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Pro Fee Coding Specialist
Saint Francis Health System. Review medical record documentation and add or correct diagnosis and procedure codes submitted by providers .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical coding and billing, including the ability to review and correct documentation, analyze claims-denial data, and educate providers on compliance and regulations. Proficient in utilizing coding certifications and software tools to ensure accurate coding practices and improve billing performance.
Highest-signal resume keywords
Medical Coding ExpertiseClaims-Denial AnalysisCCS CertificationMicrosoft 365 ProficiencyAnatomy and Physiology Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
Medical CodingDiagnosis and Procedure CodingCoding and Billing RequirementsCharge CorrectionsEncoder SkillsCoding SpecificityDocumentation ReviewBilling PoliciesPreventative Measures DevelopmentPerformance Monitoring
Soft Skills
CollaborationIndependent WorkTime ManagementCommunicationProblem-Solving
Tools & Technologies
Medical Coding SoftwareBilling SoftwareMicrosoft 365
Certifications & Qualifications
CCSCPCBCHH-CRHIARHITHCCS
Industry Keywords
Medical RecordsHealthcare ComplianceCoding RegulationsDocumentation StandardsBilling Performance
About the role
Key responsibilities & impact- Review medical record documentation and add or correct diagnosis and procedure codes submitted by providers
- Code assigned records using current coding and billing requirements
- Monitor coding and billing performance and resolve denials related to coding errors
- Review charge corrections and rebilling for coding-denial resolution
- Analyze claims-denial data and develop preventative measures
- Prepare periodic reports for clinical staff identifying corrective measures
- Advise and instruct providers on documentation and billing policies, procedures, and regulations
- Obtain clarification for conflicting, ambiguous, or nonspecific documentation
- Educate providers and office staff on documentation, coding, billing changes, and regulations
- Collaborate with providers, office staff, billing personnel, quality, compliance, and coding resources
- Stay updated on coding rules and attend seminars and review coding periodicals
- Work directly with patients, customers, healthcare professionals, and staff
Requirements
What you’ll need- Previous experience strongly preferred
- Minimum education: GED or High School diploma
- Must hold one of the following certifications: CCS, CPC, BCHH-C, RHIA, RHIT, or HCCS; applicants without a required certification must obtain one within one year of hire
- Knowledge and/or training in anatomy and physiology of the human body and disease processes preferred
- 2 years related experience preferred
- Sound knowledge of medical records and coding specificity
- Basic encoder skills
- Knowledge of Microsoft 365 and applicable software
- Ability to determine whether records are complete enough to code
- Ability to work independently and collaboratively in a fast-paced environment
- Ability to manage multiple priorities and competing deadlines