The Coding Specialist reports to the Coding Manager and is responsible for correct coding of professional services and upholding compliance standards.

The Coding Specialist I is required to:

* Perform coding and related duties using established Professional Billing Office and Coding Services policies in an accurate and timely manner. Review medical documentation and system generated charges or paper encounter forms. Appropriately assign CPT, ICD-9/ICD-10, HCPCS II, and modifiers based on documentation and payor requirements.

* Demonstrate a commitment to integrating coding compliance standards into daily coding practices. Identify, correct and report coding problems.

* Maintain current knowledge of coding, compliance and reimbursement procedures. Review current literature, newsletters, payor policy updates and coding manuals.

* Resolve coding edits and denials in a timely manner. Identify opportunities to reduce denials and enhance revenue.

* Function as a resource to Professional Billing Office units and external customers. Research and resolve coding inquiries. Make recommendations for coding policy changes. Participate in the electronic or paper encounter form revision process to ensure correct coding standards are met.

* Develop and maintain division specific coding procedures.

* Complete special projects as assigned by management which require defining problems, determining work sequences, summarizing findings, and implementing required changes.

* Participate in coding education for providers and co-workers.

* High school diploma required

* Completion of a Coding Certificate program or Health Information Technology Program or work experience equivalent required.

* Experience in coding, billing, and knowledge of insurance reimbursement policies and regulations or equivalent experience is preferred but not required if one has completed a Coding Certificate or Health Technology Program.

* Course work in anatomy and physiology, medical terminology is strongly preferred

* Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is strongly preferred. Certification may include CPC, CPC-H, CCS, CCS-P.

• Proficient in ICD-9, ICD-10, CPT, HCPCS, and modifiers for coding of professional fee services.
• Working knowledge of anatomy and physiology, medical terminology and insurance reimbursement policies and regulations.
• Excellent written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required.
• Accuracy and attention to detail
• Proficient with computer applications (MS Office etc), good data entry skills

The Professional Billing Office is located in the Charlestown Navy Yard campus.