So if you’re a medical coding specialist, job opportunities abound. I provide dedication, commitment, loyalty and perseverance to any company that I work for. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards, As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes, One year clinical experience to include general office skills and computer experience, Demonstrated proficiency working with Epic work queues as well as prior charge posting experience, Strong computer skills; understanding of RIS system, Adobe Acrobat experience and experience working collaboratively on projects using Microsoft SharePoint experience, Demonstrated proficiency in spelling, punctuation, and grammar skills, Demonstrated customer service and organizational skills, Excellent verbal and written communication skills and have the ability to function under the pressure of daily work requirements, Demonstrates experience in professionally handling and protecting items confidential in nature, Communicates effectively with internal and external sources concerning diagnoses and procedure(s) to assure proper coding and reimbursement, Six months of prior CPT-4, ICD-9 and ICD-10 coding experience, One year of prior CPT-4, ICD-9 and ICD-10 coding experience, One year prior CPT-4 and ICD-9 coding experience, Research and analyze the medical records when there is a discrepancy in coding; validate the coding and supporting the department in the reporting of findings, Demonstrated skill/experience working with computerized reports to abstract information, Good interpersonal skills and a basic understanding of team management concepts, Good communication skills both verbally and written and the ability to communicate clearly and concisely, Strong computer, customer service and communication skills, Organizational skills to prioritize workload and meet deadlines; develop and carry out project assignment in an efficient and timely manner, Skill and ability to communicate effectively both orally and in writing, Patient Skills Types: Inpatient Acute Hospital, 1) Experience with Outpatient Coding (transforming descriptions of medical diagnoses and procedures into universal medical code numbers), 3) Experience with reviewing complex patient data and being able to investigate a solution, Experience coding patient records in a hospital HIM department, Two (2) years of experience with ICD-9 and CPT coding, Patient Skill Types: Inpatient Acute Care, Patient Skill Types: Inpatient Acute Hospital; Observation; Same Day Surgery, Skill and ability to maintain working relationships with physicians and other staff, Skill and ability to research and analyze data, draw conclusions, and resolve issues, Skill and ability to review the work of others and maintain confidentiality, Demonstrates ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner, Demonstrates ability to learn and work independently, Ensures pre-certifications/authorizations are valid for the procedure performed, Uses only pre-approved source documents as validation for recommendations, Validate and abstract CPT, ICD-10 and HCPCS codes from professional and facility medical documentation, At least 3-5 years experience as a medical coder, Examining and verifying coding errors through audits, Correcting rejected claims, researching, and contacting physician offices, Reprocessing and researching of coding denials, Understanding of ICD - 10 Coding in relation to DRGs, Tracking their own continuing education credits to maintain professional credentials, Answering Medical Representatives coding questions, Providing timely bill processing per state guidelines, Coding Certification required; CPC or equivalent certification, Willing to travel to provider offices in Orange county, Works in conjunction with the Reimbursement staff to answer all inquires regarding coding and billing for physicians' services, Trains clinical staff on coding guidelines, ensuring compliance around documentation, coding and payor guidelines, Updates physicians and managers of regulatory and coding system changes, reviews training needs and creates and implements training plans as needed, Maintains updated knowledge of coding requirements; including continuing education and certification renewal, Communicates with families, assisting with billing/insurance questions and collecting surgical prepayments, Our coding colleagues work for coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to nThrive, Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for physicians' services, Assist coding trainer with all training/audits or retraining audits, Adapt to continually changing coding requirements and regulations, Provides regular and on-going communication with management and medical staff to resolve coding issues and associated problems, Collaborates with the coding team at the external billing company, Audit medical records to ensure compliance with the organizations coding procedures and standards according to government regulations, Medical Billing/Coding Diploma or Certificate Required (CPC), A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement, Identify appropriate assignment of CPT and ICD -10 Codes for physician and facility services provided in an Observation service setting, and Inpatient setting, Comply with all legal requirements regarding coding procedures and practices, Acts as a liaison between the CBO (Central Business Office) department, billers, and third party payers in resolving billing and reimbursement accuracy, Report coding problems or irregularities to Coding leadership as appropriate, Contact leadership, billing, and or coding representatives for information and assistance with denied or incorrectly paid claims, Assists in finding resolutions to billing issues – rejections, non-paid accounts, etc, Advise physicians on a day-to-day basis regarding documentation and coding standards, Advise physicians on a day to day basis regarding documentation and coding standards, Responsible for maintaining current knowledge of coding guidelines through the use of current CPT, HCPCS II and ICD10 materials, Communicates with staff, relaying messages or other information relevant to maintaining timely workflow and customer satisfaction, Performs all audits of documentation, coding and billing practices in whatever office or capacity it is required, Assists with working the missing condition reports from all carriers, Assists with all quality measures initiatives – working with the PCP offices in capturing the data to support the variables, Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary, Perform ongoing analysis of medical record charts for the appropriate coding compliance, Sequences the diagnoses and procedures using coding guidelines, Acts as liaison between the Billing Department and medical staff, clinical staff for coding and documentation issues, Maintains knowledge of and complies with coding guidelines and reimbursement reporting requirements, Our coding colleagues code records for multiple clients where the hospital has outsourced either all or a part of the coding functions to nThrive, Support Director of Risk Adjustment Coding with department projects including some project management, Presenter of HCC Coding Education to network providers with Medical Directors (evening workshops), Assist with coding supervisors and coding staff to ensure that concerns are investigated and appropriate action is taken, Assists and confers with other coders and Coding Manager concerning any problem records, Prepare individual report for each Level 1 audit to the supervisor/trainer, identifying and communicating potential quality issues, Assist with auditing on MRTS in incomplete and unbillable chart reviews, or any other department reviews to ensure coding accuracy and adherence to policies, Assist with coding and/or correcting charts sent by all departments, Assists with US Oncology audit and compliance or reimbursement audits such as providing records, audit reports, and standard operating procedure manuals, Interacts with clinician and other clinic/corporate departments to assure completeness of charts for billing, Interacts with Medical Billers to assure compliance and appropriate billing practices, Be a key player in the revenue cycle process by working closely with the client’s HIM and other support departments, Ensure compliance with CMS’s Diagnostic Coding Guidelines for Hospital-based Outpatient Services, Reviews billing and/or EMR system to identify and analyze trends, recommend and implement corrective actions, Medical coding through medical record abstraction, Proficient knowledge of medical terminology, ICD-10 and CPT coding, Look into any coding errors and ensure resolution, Coding Technical Skills –Regulatory coding (ICD-9-CM, ICD-10 and HCPCS/CPT) and associated reimbursement knowledge, Coding Technical Skills –Regulatory coding (ICD-9-CM and HCPCS/CPT) and associated reimbursement knowledge, Coding Technical Skills – Regulatory coding (ICD-9-CM, ICD-10 and HCPCS/CPT) and associated reimbursement knowledge, Medical coding experience with demonstrated sustained coding quality, Exemplary attention to detail and critical thinking skills, Effectively present coding issues to internal or external clients, Adaptability to change and learning new skills, Prior experience with correcting diagnosis codes and modifiers assigned to outpatient services, 18+ months prior medical coding experience, Prior Evaluation and Management or Surgical coding experience, Prior experience in a role/s within a medical office environment, Third party medical billing and coding experience from Evaluation and Management documentation and coding experience from a narrative/report format, Four ( 4 ) years experience in CPT-4 and ICD-9-CM coding and abstracting experience for a physician office, hospital or insurance carrier multi-specialty areas, Works efficiently and effectively to minimize overtime, Coding experience in obstetrics, primary care or oncology, CCS coding credential requires inpatient coding experience before taking exam, Charge entry/cleaning claims for coding accuracy prior to submitting to insurance, Recent and relevant hands-on coding experience including active production coding, Recent and relevant hands-on coding experience including active medical production coding, Professional Coding experience in a Hospital or Physician setting, Inpatient Coding experience in a Hospital setting, Demonstrate flexibility to accommodate rapidly changing needs of a growing organization, Experience in a healthcare environment dealing with medical coding, Experience using ICD and CPT coding systems, 6 months or more of experience in medical coding, Good working knowledge of medical terminology and anatomy required, ICD-9 Coding or Medical Record Audit experience in a consultative role, Strong problem solving and resolution abilities, Experience using Athena Health practice management or a similar system is required, Experience using ICD-9-CM, CPT, HCPCs or equivalency, Minimumof two years related coding experience required, Experience with coding and reimbursement activities, Demonstrated knowledge of ICD-9 and CPT4 Coding, Excellent understanding of clinical documentation requirements in order to support an active diagnosis, 6 months or more of medical coding experience, Experience in Medical Coding (ICD-10, CPT, and HCPCS), Or more of professional experience in clinical/medical setting, Medical Coding Certificate-currently valid (CPC through AAPC) or (CCA or CCS through AHIMA), Knowledge of or experience with ICD-10 and CPT coding, ME/Team Lead experience working with cross functional teams, Experience in working in a healthcare insurance environment, One (1) year of recent and relevant hands-on coding experience, Demonstrates ability to work in a team environment, and to build trust in the working relationships with other staff and faculty, Monitor and report the effectiveness of internal/external understanding of LHI services, Demonstrates knowledge of ICD-10-CM and CPT coding guidelines and medical terminology, Five years of experience in hospital inpatient coding required, Profee/physician coding experience is required, Organize and prioritize and meet deadlines, Excellent knowledge of medical record review and abstraction, Demonstrated knowledge of ICD-10-CM, CPT, PQRS (Physician Quality Reporting System-Medicare), and HCPCS coding guidelines and principles required, Able to demonstrate full knowledge of insurance payers and their coding requirements per their Clinical Policy Bulletins, NCCI edits and Medicare LCDs, Strong ICD-10, HCPCS and CPT Coding knowledge, Prioritize responsibilities and meet deadlines, Coding experience in a medical office environment, CPC, CRC, CCS-P, or CPC-A (with experience) coding certification, CPC, CPC-A (with experience), CRC, or CCS-P Coding Certification, Experience with Medicare, Medicaid, and commercial carrier coding guidelines, Experience using a computer and Microsoft Office (Microsoft Word, Microsoft Excel, and Microsoft Outlook) to create, copy, edit, send, and save documents, Experience in defining business requirements, traceability and system configuration, At least 1-year medical coding experience, Working knowledge of medical terminology, basic coding skills including familiarity with ICD-10 and CPT coding is required, Working knowledge of medical terminology, basic coding skills including familiarity with ICD-10 and CPT coding (required), Previous experience coding for PCP and / or skilled nursing facilities, or specialty clinics, Work independently and proactively with critical thinking skills, Coding experience in either inpatient or outpatient setting, Of 3 yrs. 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