Medical Coding Specialist II

Company: MEDNAX ( Learn More )

General Information
US-TX-Arlington
N/A
2 Year Degree
Full-Time
Not Specified
Not Specified
False
False
Job Description Overview

MEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:

  • physician services spanning the continuum of patient care
  • revenue cycle management solutions
  • performance improvement consulting
  • We invite you to grow with us and help shape the future of health care.

    The Revenue Integrity Analyst/Auditor is responsible for performing coding quality audits of medical records to assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and to provide ongoing feedback and analysis of the education needs for the providers and staff. Also responsible for providing assistance with coding inquiries from providers, charge poster/coders, and billing staff.

    MednaxCorp



    Responsibilities

  • Review charts for accurate and timely coding that is supported by medical record documentation.
  • Provide guidance on documentation requirements, queries, and documentation improvement processes.
  • Communicates coding and DRG findings to management, including applicable references, as appropriate.
  • Research, analyze, and respond to inquiries regarding compliance, inappropriate coding, denials, and billable services.
  • Provide technical support to medical providers, as appropriate, regarding coding compliance documentation, regulatory provisions and third-party payer requirements.
  • Identify trends and educational opportunities.
  • Assist with other audits as requested.
  • Evaluate the quality of clinical documentation to identify incomplete or inconsistent documentation that could impact the quality of data being reported.
  • Audit codes and professional fee services performed by providers from medical records according to ICD-10, CPT, ASA, and CMS guidelines.
  • Maintain up-to-date knowledge of coding such as appropriate documentation, accurate coding, coding trend found during chart reviews, third-party audit findings, and annual coding updates.
  • Evaluate and provide appropriate documentation for the third-party payer CPT denials to maintain the original CPT assignment, and when necessary, implement corrective action plan and/or educational programs to prevent similar denials and rejections from recurring.  
  • Serve as a resource to the office staff, providers, and billing department.
  • Perform other job-related duties within the job scope as assigned.
  • Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
  • Present a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.
  • Conduct all business in a professional manner maintaining respect for individuals at all times.
  • Comply with departmental and company-wide policies and procedures.
  • Summary of job responsibilities:
  • Coding Charts 15%
  • Annotations/Audits   75%
  • Denials, Editor, Suspense 10%


  • Qualifications

  • Associate's degree (A.A.) or equivalent from a two-year college or technical school; Coding Certification (CPC or AHIMA).
  • CANPC, RHIT or 2+ certifications by a nationally recognized coding and accreditation program that requires CEU submission for renewal
  •  Coding Experience Required:  2+ plus years of experience.
  • Ability to clearly communicate medical coding information and work with other team members.
  • Knowledge and understanding of medical coding and billing systems and regulatory requirements.
  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding, billing procedures and documentation.
  • Ability to work independently to analyze and solve problems.
  • Ability to use independent judgment and to manage and impart confidential information
  • Ability to adapt, modify and prioritize audit functions as required.
  • Knowledge of personal computers
  • Ability to ensure the confidentiality and rights of patients, the confidentiality of health system and patient documents required.
  • Ability to communicate effectively both verbally and in written form.
  • Ability to perform basic math calculations.
  • Ability to identify problems, develop course of action and follow through to resolution required.
  • Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing.
  • Ability to analyze and identify opportunities in documentation improvement.
  • Excellent written communication, and analytical skills.
  • Ability to set priorities and meet deadlines
  • Knowledge of Medicare and Medicaid regulations.
  • MEDNAX IS AN Equal Opportunity Employer

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status

     #CBC

    Job Requirements