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Certified Coder (Coding Specialist)

Certified Coder (Coding Specialist)

Job Description

Would you like to join a dynamic healthcare company? A company that is looking to become the pre-eminent limited specialty ambulatory surgery provider in the US? A company that prides itself on its foundational values of integrity, responsibility, mutual respect and corporate citizenship? Now is your opportunity!
Covenant Surgical Partners is looking for the right person to fit the role of Coder- Coding Specialist in our downtown Nashville corporate office.

Under the supervision of the Coding Manager, the Coding Specialist is expected to perform all areas of coding, have knowledge of billing and account receivables resolution by utilizing approved insurance , patient billing and collections techniques. The Focus of the Coding Specialist is to assist in optimizing operations performing essential duties with accuracy in order to meet set goals. Must have experience in  ASC Coding and Hospital Coding.

Responsibilities included but not limited to:
• Performs diagnostic and procedural coding from the Operative Reports for Outpatient Ambulatory Surgery Center procedures. The coding is performed with minimal variation from the coding guidelines, unless payer driven. The patient account coding specialist should demonstrate accuracy, integrity and compliance with all the approved coding guidelines, resources and rules.
• As part of ongoing knowledge improvement process, the patient account coding specialist will stay abreast of new ICD-9 Diagnosis, CPT Procedure codes, Modifiers and guidelines.
• Employs effective and efficient billing techniques, and self-directed initiative, to resolve all types of billing edits via the SSI Billing System.
• Must have working experience with all payer types: commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross over into different payers.
•Establishes knowledge of major payers needed to identify payer rejection issues and executes the payer procedures needed to reduce the occurrence of future rejections. Experience and ability to identify billing or payer edit opportunities.
• Acts as the connection between internal and external customers to assist in the account coding and billing issue resolution process and to escalate issues which adversely impact claim resolution and payment.
• Documents all coding and billing and action needed to successfully resolve claim issues with insurances.
• Experience and ability to identify and escalate trends impeding coding and billing tasks.
• Ability to perform independent research prior to seeking management assistance.
• Follows department QA policies and procedures defined by department as required to meet payer and regulatory requirements related to claims coding, billing and payer claim rejection resolution including procedures related to release of information, record retention, privacy and confidentiality.
• Provides information to Manager in identifying possible areas of concern that impact account coding and billing, accurately and in a timely manner.

Job Requirements

• • 3 + years in Healthcare Coding experience from a technical and functional view. May consider equivalent combination of education healthcare coding and collection experience.
• Candidates must have strong experience with CPT, ICD-9, and NCCI coding, proficient in 10 key charge entry, experience with insurance processes.
• Certified Professional Coding designation (preferred).
• Word, Excel and Outlook experience is required. Ability to learn new programs and systems is required.
• Ability to effectively and correctly communicate to the staff, management and payers.
• Able to read, write, speak, and communicate clearly in English.  Bilingual skills a plus.

Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education Not Specified
Experience At least 3 year(s)
Manages Others No
Relocation No
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID 136
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Certified Coder (Coding Specialist)

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