SUMMARY: The physician coding specialist will code inpatient procedures, evaluation and management services, and inpatient and outpatient procedures submitted by the department physicians in accordance with current ICD-10CM and CPT requirements. Will inform physicians of changes that may affect reimbursement.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Gathers necessary reports and chart documentation in order to properly abstract and code services provided to patients.
Performs audits on outpatient services in accordance with established procedures and outpatient coding guidelines for capturing all diagnoses, visits, and procedures.
Assigns the appropriate ICD-10, CPT, and HCPC codes with modifiers, as appropriate.
Captures all services documented by the physicians from pathology reports.
Serves as a resource regarding insurance resolutions and coding questions.
Reconciles rejections and edits in a timely and expedient manner.
Queries the physicians on services where documentation is inconsistent and/or incomplete for coding purposes. Codes only those services that are supported with acceptable documentation.
Provides education to physicians within practice to enhance their billing capability on a monthly basis. Provides feedback to physicians on their coding and/or documentation.
Works with IRT on coding updates and entry into billing system.
Participates in all audits that affect the Department and coordinates the appropriate information to auditors.
Keeps up-to-date on all procedures, guidelines, notices, and policies related to areas of coding and reimbursement.
Understands and adheres to Rowan University’s compliance standards as they appear in the School’s Code of Conduct. Completes all University Office of Business Conduct training.
Acts as a resource to medical coders.
Assists in the development and implementation of policies related to documentation and coding.
Performs other duties as assigned.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE: Must be CPC or CCS-P certified with a minimum of three years related experience. Knowledge of medical terminology, anatomy and physiology. Knowledge of Medicare, Medicaid, and third-party payer coding and billing regulations. Knowledge of Medicare Teaching Physician documentation requirements.
NOTE: Only completed, online applications submitted on or before the deadline will be considered.
Internal Number: 494812
About Rowan University
A leading public institution, Rowan University combines liberal education with professional preparation from the baccalaureate through the doctorate. Rowan provides a collaborative, learning-centered environment in which highly qualified and diverse faculty, staff, and students integrate teaching, research, scholarship, creative activity, and community service. Through intellectual, social and cultural contributions, the University enriches the lives of those in the campus community and surrounding region.