Medical Coding & Billing Specialist

Job Description:

The Medical Coding and Billing Specialist role serves as the subject matter expert on documentation requirements and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding guidelines, overseeing comprehensive coding reviews to ensure accuracy, compliance with Centers for Medicare & Medicaid Services (CMS) and Cityblock standards, and proper documentation; querying providers as needed, maintaining audit logs, analyzing trends, and ensuring ongoing communication with provider teams, all while ensuring adherence to legal and procedural coding requirements.

Responsibilities:

• Serves as the subject matter expert on documentation requirements and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding guidelines

• Conducts coding review on all provider documentation to assign the correct ICD-10-CM codes and ensures all documentation is accurate, precise, and adherent to Centers for Medicare & Medicaid Services (CMS) guidelines

• Queries providers to ensure that appropriate documentation appears in the medical record

• Maintains log of all documentation audits and conducts ongoing follow up activities and communication for uncompleted or unanswered queries

• Assists with analysis, trending, and presentation of audit findings, outcomes, and issues

• Ensures adherence to Cityblock's coding guidelines and any necessary updates are shared across the teams.

• Develops a foundational understanding of existing Electronic Medical Records (EMRs) and processes to surface risk opportunities

• Complies with all legal requirements regarding coding procedures and practices

Work Experience:

• 5+ years of overall experience, and 3+ years of outpatient risk adjustment coding, Chronic Disease and Payment System (CDPS) documentation requirement understanding a plus

We take into account an individual's qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company's equity program, paid time off, including vacation and sick leave. The actual offer will be at the company's sole discretion and determined by relevant business considerations, including the final candidate's qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:

$64,000.00 - $82,000.00 Annual

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.