Coding Specialist

• Research, collect, and analyze information to identify opportunities and develop solutions
• Collaborate on performance improvement activities based on program efficiency and patient experience outcomes
• Distribute analytical reports
• Use multiple system applications to perform analysis, create reports, and develop educational materials
• Research and compile information for ad-hoc operational projects and initiatives
• Synthesize and analyze data, provide detailed summaries and graphical presentations, illustrate trends, and recommend practical solutions
• Leverage program and operational data to define and demonstrate progress, ROI, and impacts
• Ensure accurate CPT/HCPCS documentation for patient billing
• Educate colleagues, clinical staff, and ancillary departments on accurate documentation and appropriate coding
• Perform charge capture and review charts, nursing notes, physician orders, progress notes, and surgical or specialty notes to validate or extract charges
• Verify charges are assigned to the correct patient, encounter, date of service, and required modifiers
• Review documentation and ensure charges and coding align with AMA and Medicare coding guidelines
• Perform CPT and ICD-10 coding, documentation review, and claim denial review
• Work pre-bill edits including OCE/CCI and DNFB within key metrics
• Provide at-elbow support to ancillary departments, including supply and implant charge capture, duplicate charge identification, and resolution of documentation or charge errors
• Perform charge entry, charge approvals, and quality charge reviews, including modifier appending and clinical documentation checks
• Validate charges for complex service lines and surgical or specialty coding practices
• Provide feedback to Revenue Integrity colleagues on areas of opportunity

Specialist Charge Revenue Integrity – Surgery Coding

• Research, collect, and analyze information to identify opportunities and develop solutions
• Lead performance improvement activities based on program efficiency and patient experience outcomes
• Distribute analytical reports
• Use multiple system applications to perform analysis, create reports, and develop educational materials
• Research and compile information for ad-hoc operational projects and initiatives
• Synthesize and analyze data, provide detailed summaries and graphical trend presentations, and recommend practical options or solutions
• Leverage program and operational data to define and demonstrate progress, ROI, and impacts
• Ensure accurate CPT/HCPCS documentation for patient billing and educate colleagues and ancillary departments on accurate documentation and appropriate coding
• Perform charge capture in assigned Revenue Integrity areas
• Review charts, including nursing notes, physician orders, progress notes, and surgical or specialty notes, to interpret, validate, and extract charges
• Verify charges are assigned to the correct patient, encounter, date of service, and required modifiers
• Review documentation and abstract data to align charges/coding with AMA and Medicare coding guidelines
• Perform CPT and ICD-10 coding, documentation review, and claim denial review
• Work pre-bill edits including OCE/CCI and DNFB within key metrics
• Provide at-elbow support to ancillary departments, including supply-charge capture, duplicate-charge identification, and correction of documentation or charge deficiencies/errors
• Perform charge entry, charge approvals, and quality charge reviews, including appending modifiers and checking clinical documentation
• Provide feedback to Revenue Integrity colleagues on improvement opportunities
• Code and/or validate charges for complex service lines and advanced surgical or specialty coding practices
• Educate clinical staff on accurate and complete documentation for revenue optimization and integrity
• Comply with Trinity Health’s mission, values, policies, procedures, Code of Conduct, and safety practices

• Review and write appeals for inpatient Diagnosis Related Group (DRG) denials
• Support assigned DRGs and address clinical documentation used to validate assigned codes
• Determine potential billing/coding issues and quality concerns
• Participate in client system education
• Review client accounts to ensure coding is supported by clinical documentation, coding/CDI guidelines, and regulatory standards
• Maintain documentation, spreadsheets, account records, and claim examples of root-cause issues
• Research governmental, payer-specific, hospital-specific, regulatory, and literature rules and guidelines
• Make coding and billing recommendations to clients
• Assist with education and training for client coding companions based on coding appeals outcomes
• Meet established productivity standards and coding certification requirements
• Attend in-house sessions for updated coding and regulatory information
• Provide organized, efficient customer service

Acute Coding Appeals Specialist

• Evaluate documentation using coding and clinical expertise to ensure coding specificity and accuracy
• Provide guidance and education to coders, providers, medical assistants, practice managers and ancillary staff
• Educate staff on clinical documentation best practices and correct coding
• Work remotely and travel within areas served by BHMG

Coding Specialist jobs in United States

Specialist Charge Revenue Integrity – Surgery Coding

Specialist Charge Revenue Integrity – Surgery Coding

Acute Coding Appeals Specialist

Coding Education Specialist