Coding Reimbursement Specialist II

Coding Reimbursement Specialist II   Job Summary :

• The Coding Reimbursement Specialist II performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system. (This is a full-time position with remote eligibility, Monday to Friday 8 am to 5 pm)   Primary Job Responsibilities / Tasks may include, but not limited to : Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA.
• Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services.
• Performs other related duties as required and assigned.

Requirements :

Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.

Experience :

Physical Requirements :