Coding Specialist II

At Terry Reilly we believe we are successful when we have a healthy, thriving community. This is accomplished as a result of our mission-driven and talented team.

We provide integrated care throughout the Treasure Valley with our medical, dental and behavioral health services - allowing our employees the unique ability to experience several disciplines of health care. It is important to us that our staff is given a healthy work-life balance, so we support and value your time in and out of the office. We also provide our employees with excellent benefits including options for low-cost healthcare.

GENERAL RESPONSIBILITIES

Has overall responsibility at all sites within Terry Reilly to support, train and audit clinician staff on the proper use and research techniques for CPT and ICD-10 coding consistent with the AAPC and CMS coding guidelines.

ESSENTIAL DUTIES

1. Assist with onboarding training all new clinician staff on the guidelines of determining a proper CPT and ICD-10 code within 1 week of their start date.
2. Responsible to maintain regular provider audits for new and existing clinicians. Ensures that audits are completed in a timely manner and results are reported to Medical Directors, supervising clinicians, and Coding Supervisor.
3. Responsible for monitoring reports of all clinicians on a quarterly basis to identify new or ongoing trends in code usage. This includes producing a quarterly report on code usage by clinician and location and distributing it to the appropriate personnel.
4. Perform detailed chart audits on new clinician encounters and chart notes 30-45 days after initial training (10-15 unbilled encounters from first month worked).
5. Assists with scheduling and conducting quarterly refresher courses for clinicians, including but not limited to, problem areas in our organization, changes in coding and areas of further development and interest. Identifies need and resources for in-house training for clinicians and Patient Financial Services staff.
6. Make necessary recommendation for coding or documentation update needs and provide training as needed.
7. Assist in working with payors to review documentation and coding to meet quality incentives for risk adjustment and care gaps.
8. Maintains professional competency through continuing education opportunities and attendance of professional meetings and workshops.
9. Assists with Dental clinical workflows, coding, and other support as needed.

MARGINAL DUTIES

1. Other duties as assigned by Supervisor.
2. Serves as primary source of reference for clinicians, lab and back-office staff when coding questions arise.
3. Assists the Coding Supervisor to develop and maintain training manual for these departments including information on coding guidelines.
4. Support PFS staff with coding concerns and or review of claims to determine potential coding issues
5. Maintains complete record of training attendance/topic reports for all trainings.

MINIMUM QUALIFICATIONS

1. 2 years CPT and ICD coding experience.
2. Certified Professional Coder (CPC-A) credential or equivalent education. Recognized professional certification (IE CPC, CCA, etc.)Strong medical billing background including diagnosis codes and disease states.
3. Strong understanding of clinical workflows
4. Extensive knowledge of medical billing terminology and billing requirements, chart note interpretation.
5. Auditing of chart notes and maintain courteous and professional communication with providers.
6. Strong verbal communication skills.
7. Competence with spreadsheet (Excel) and word processing (Word) programs

PREFERRED QUALIFICATIONS

1. Bilingual English and Spanish.

Terry Reilly Health Services is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected Veteran status.

Current Openings for Coding Specialist II Jobs at Terry Reilly Health Services