Firelands Regional Medical Center - Sandusky, OH
posted 2 days ago
About the position
The Coding & Reimbursement Specialist plays a crucial role in the healthcare system by assigning ICD-10-CM/PCS, CPT-4/HCPCS codes and outpatient billing edits for various medical services. This position operates under the general direction of the Manager of Coding and is responsible for coding for inpatient, ambulatory surgery, emergency services, and outpatient diagnostic services. The role ensures compliance with federal regulations and contributes to revenue cycle initiatives. The specialist also performs internal coding quality assessments to maintain adherence to coding guidelines and organizational policies. The position is integral to optimizing reimbursement processes and improving overall coding accuracy.
Responsibilities
- Assign ICD-10-CM/PCS, CPT-4/HCPCS codes for diagnosis and procedures for various medical services.
- Code outpatient encounters for billing and data retrieval, ensuring medical necessity.
- Abstract statistical data from medical records using the Medical Center's abstracting system.
- Utilize software to identify and correct potential billing problems before submission.
- Review medical records for optimal charge capabilities and identify potential errors.
- Follow up on deficient accounts to ensure prompt claim release to billing.
- Participate in process improvement initiatives within the revenue cycle.
- Perform internal coding quality assessment reviews to ensure compliance with coding guidelines.
Requirements
- Two year Associate Degree preferred.
- RHIA, RHIT, or CCS eligible certification required, with current credentials and continuing education credits.
- Six months or more experience in assignment of ICD-10-CM/PCS codes to medical diagnosis.
- Proficient in coding encoder software, Electronic Medical Record software, Outlook, and Medical Necessity software.
Benefits
- Competitive pay
- Excellent benefits
- Tuition assistance
- Retirement plan matching
- Recognition program
- Local discounts
