Summary Description:
Under general direction, this position will be responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Cardiology Coding Specialist works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition, this role monitors and analyzes coding performance at the section and business unit levels. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention.
Essential Duties and Responsibilities:
- Review charts and capture all reportable services.
- Coordinate with other coding staff to ensure all reportable services are captured and assigned to appropriate physician or ARNP.
- Assign all appropriate ICD codes, CPT codes, and modifiers per ICD, CPT, and Medicare or commercial carrier published guidelines. Enter charges, review WQs to address edits/denials.
- Review work queues in EMR and resolve coding issues for professional services for both hospital and clinic places of service.
- Reconcile charges monthly to ensure capture of all reportable services.
- Work with business office to resolve hospital billing questions/coding denials or concerns.
- Assist employees and physicians in providing coding guidance. Ability to communicate effectively both orally and in writing.
- Pull audit reports and back up documentation for internal audits.
- Comply with all legal requirements regarding coding procedures and practices
- Conduct audits and coding reviews to ensure all documentation is precise and accurate
- Assign and/or review the sequence of all CPT and ICD 10 codes for services rendered
- Collaborate with AR teams to ensure all claims are completed and processed in a timely manner
- Support the team with applying expertise and knowledge as it relates to claim denials
- Aid in submitting appeals with various payers about coding errors and disputes
- Submit statistical data for analysis and research by other departments
- Ability to identify PSI triggers or have working knowledge of PSI triggers which includes identifying and assigning co-morbidities and complications.
- Ability to assign the appropriate DRG, discharge disposition code and principal DX codes
- Serves as the liaison between revenue cycle operations and clients as it relates to charge capture documentation and reconciliation
- Possesses a clear understanding of the physician revenue cycle
- Oversees understands and communicates coding and charging processes for each client account based on their existing EHR system as it relates to office and hospital-based services which includes charge captures charge linkages to the CDM and charging processes.
- Analyzes and communicates denial trends to Clients and operational leaders.
CPC or CCS coding credentials required. Cardiology experience preferred. EMR, eCW, Centricity, Epic, Encoder Pro or 3M experience highly desired.
Microsoft Office Skills:
Excel – Must have the ability to create and manage simple spreadsheets.
Word – Must be able to compose business correspondence.
License:
- CPC, CCC or CCS (Required)