Senior Coding Specialist (Inpatient)

Job Description

Provides guidance to team members to ensure proficient operation of the Patient Financial Services department. Functions as a liaison between physicians' and ancillary departments in the instruction of regulatory guidelines. Researches and resolves complex assignments.

Job Responsibility

• Monitors system files to ensure the efficient, expeditious processing of all re-billed encounters; identifies and implements solutions to process issues as needed. Researches and resolves complex assignments; serves as on-site resource for coding and charging issues. Responsible for in servicing coding/clinical staff of changes that take place in the coding system; encourages communication between departments to resolve coding and billing issues. Validates coding system maintenance forms prepared by Financial Analysts in a timely manner; ensures coding system codes and revenue codes are in compliance with the Federal Register and other regulatory agencies. Uses all coding resources, including researching availability of additional documentation to assign accurate system codes; monitors code editor report to analyze, research and resolve issues related to Medicare outpatient claims that generate code editor edits.
• Maintains current knowledge base of regulatory & coding guidelines, billing processes, Ambulatory Payment Classification (APC) groups, federal, state and regulatory agency coding and reimbursement changes and coding requirements to ensure hospital procedures and services are properly ordered and charged for.
• Conducts departmental coding/documentation audits to identify the education needs of the department; assists in the education of the outpatient revenue specialists as identified through the audit process. Conducts educational sessions with department staff, Department Heads and clinical staff members to ensure proper maintenance procedures.
• Operates under limited guidance and work assignments involve moderately complex to complex issues where the analysis of situations or data requires in-depth evaluation of variable factors.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.
• Current Professional Coder Certification, or Current Coding Professional Certification required, plus specialized certifications as needed.
• 3-5 years of relevant experience, required.
• Prior experience with hospital Inpatient coding, preferred.
• Proficient in Excel, preferred.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).