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Coding Specialist - Primary Physician Network-CBO - Full-Time at Mercy Medical in South Bend, Indiana

Posted in Other 30+ days ago.

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Job Description:

14001_54700 Patient Access - Coding
Expected Weekly Hours:
Day Shift

Position Purpose:
Ensures medical documentation and coding is in compliance with federal, state, and all other payer regulations. Provides
accurate, complete, and timely diagnostic and procedure codes for the billing system used by Saint Joseph Physician
Network for physician billing of office visits, office procedures, hospital admissions, subsequent visits, and discharges.

Job Description Details:

minimum $16.46 maximum $24.70

1. Actively demonstrates the organization's mission and core values, and conducts oneself at all times in a manner

consistent with these values.

2. Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information.

3. Reviews and assigns accurate and complete diagnosis and procedure codes according to charted medical

documentation from the encounter form and/or medical record in accordance with ICD-9 and/or CPT coding

guidelines or other mandated coding systems which may be required to meet federal guidelines.

4. Reviews and assigns accurate and complete diagnosis and procedure codes according to the hospital charge

sheet and/or medical record in accordance with ICD-9 and CPT coding.

5. Ensures all office, nursing home, and hospital charges are entered accurately and in a timely manner. This may

require verification with the physician/healthcare provider of the appropriate CPT code, ICD-9 code, level of

service, and/or modifier.

6. Verifies patient demographics and insurance information are accurate in the computer. Depending on the

ambulatory care office, may be required to enter such information into the computer.

7. Reviews the ADP Scrubber edits and keeps those edits current.

8. Places charges on hold from billing to payers for additional documentation when incomplete or inaccurate coding is

in question.

9. Verifies uncertain documentation by contacting medical office site, physicians, or hospital for the medical record

that will be reviewed.

10. Queries medical records and refers to the Internal Audit Department (Compliance) those that contain conflicting or

unclear documentation that could effect the code assignment.

11. Understands importance of relationship between the Central Billing Office and the Internal Audit Department

(Compliance). Interfaces with the Central Billing Office teams and enhances these interfaces by sharing knowledge

and skills with team members.

12. Maintains high level of accuracy, speed, and confidentiality based on recommended external productivity


13. Keeps informed of all changes and revisions in the coding profession by reading and retaining knowledge of all

articles and newsletters available. Utilizes all available resources including online coding information.

14. Keeps abreast of all updates and changes in insurance plans and government rules and regulations to ensure

accurate coding and charge entry.

15. Participates in seminars and continuing education activities pertinent to areas of job responsibility and maintains

skill level and proficiency.

16. Maintains "Certified Professional Coder" credentials on an annual basis. Remains current on federal, state, and

payer-specific coding, documentation, and billing regulations and continuing education requirements.

17. Performs other duties consistent with the purpose of job as directed.

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.