Coding Specialist II-Pathology
Medical College of Wisconsin
POSITION IDENTIFICATION
Position Title: Coding Specialist II
Department: Pathology
Location: Dynacare Lab Building
Workweek: This position is anticipated to work 40 hours per week. Scheduling flexibility is required to accommodate changing business needs.
SUPERVISORY RELATIONSHIPS
Reports to: Department Admininstrator
Collaborates with (if applicable): Financial Manager, CPS staff
Directly Supervises: None
POSITION PURPOSE
Perform coding and related duties using established billing office policies in an accurate and timely manner. Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff. Coordinates professional service billings for selected clinical departments.
Build Trust: Operate with transparency, no hidden agenda; place confidence in colleagues, give proper credit to others. Follow through on agreed upon actions. Treat sensitive or confidential information appropriately. Keep emotions under control. Exhibit ethical and moral behavior in everyday business conduct.
Foster Communication: Demonstrate ability to carefully listen to others at all levels of the organization. Seek and listen to feedback and be approachable. Express thoughts and ideas effectively. Display and promote cross cultural sensitivity.
Display Stewardship: Understand business implications of decisions. Conserve organization resources. Look for ways to improve and promote quality. Take personal responsibility. Use resources in an efficient and cost-effective manner.
ESSENTIAL DUTIES
In order of importance
1. Accurately code inpatient and outpatient physician/non-physician practitioner services through review of medical record documentation and encounter forms. Assign CPT procedure codes, ICD-9-CM diagnosis codes, HCPCS II codes and modifiers based on documentation, payer requirements, government teaching physician documentation requirements and billing office policies. Maintain adequate knowledge of coding, compliance and reimbursement procedures through review of information provided by billing office, payer policy updates and coding manuals.
2. Identify, report and resolve coding and reimbursement issues with physicians, department administrators and other billing office staff, including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.
3. Develop and maintain coding and billing procedures specific to that position and division.
4. Provide education for physicians, department administrators and support staff on procedure and diagnosis coding, medical record documentation, billing processes, policies and procedures. Promote compliance with the same.
OTHER DUTIES
Perform other duties as assigned.
MINIMUM POSITION QUALIFICATIONS
Appropriate education and/or experience may be substituted on equivalent basis
Education: High School Diploma
Experience: Three years of related experience including minimum of 1 year performing CPT and ICD-9 coding. Associate Degree with RHIT or a Bachelors degree with RHIA can be substituted for 1 year of CPT and ICD-9 coding experience. Experience in coding multi-specialty physician services preferred.
Certifications/Licenses: Coding certification (CPC, CCS-P) and/or health information management credential, RHIT (formerly ART), RHIA (formerly RRA); OR nursing/healthcare related degree preferred.
KNOWLEDGE, SKILLS, & ABILITIES
Working knowledge of E&M (Evaluation and Management) CPT coding. Familiarity with HMO, Medicare, Medicaid and commercial insurance guidelines and medical terminology. (Those located in Family Practice clinics must also have familiarity with registration.) Must possess good oral and written communication skills. Must be capable of dealing effectively with physicians, department administrators and their support staff, hospital/clinic administrators and their support staff and other contacts. Must have the ability to work independently. Basic computer skills.
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