The Coding Specialist Senior Specialty works in a team environment and is responsible to ensure accurate CPT and ICD documentation for the patient billing process. The Coding Specialist creates a positive experience for the patient and family members by addressing their billing related questions. They take responsibility for educating fellow team members and providers to accurately document services they have performed and use the appropriate code representing those services. They ensure timely depositing of patient payments and verify the accuracy of data reported by the Patient Service Representatives. Performance level position with no direct supervision. No financial/budgetary accountability but practices cost containment. Has no purchasing authority.
SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:
1. Minimum five years of experience in medical coding and billing.
2. High school graduate or GED equivalent.
3. Successfully completed CPC course and applied and been accepted to the AAPC. Must complete and maintain Certification in Procedural Coding exam within one year of hire.
4. Maintain AAPC, AHIMA or CCSP certification/membership.
ESSENTIAL FUNCTIONS:
1. Knows, understands, incorporates, and demonstrates the Organizational Mission, Core Values, and Vision in behaviors, practices, policies and decisions.
2. Must have advanced proficiencies in surgical or specialty coding practice
3. Ability to mentor other coders
4. Ability to educate and communicate with providers
5. Understanding of various medical claims formats.
6. Understanding of working on appeals for insurance denials
7. Working knowledge in medical terminology.
8. Knowledge of payer contracts and reimbursement.
9. Detail oriented with the ability to complete tasks in a timely manner.
10. Ability to work well as a team member.
11. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations.
a. Performs coding functions, including CPT, ICD-9/10 assignment, documentation review and claim denial review.
b. Responsible for proofing daily charges for accuracy and clean claim submission.
c. Responsible for balancing charges and adjustments.
d. Maintains productivity standards.
e. Maintains compliance with regulatory requirements
12. Participates in seminars and continuing education activities pertinent to areas of job responsibility.
a. Conducts coding education for physicians and staff..
13. Maintains patient confidentiality.
14. Performs daily deposits and accurately maintains Month End Reports.
15. Follows Cash Control Policy and Procedure.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Top Skills
What We Do
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity Health system includes 88 hospitals, 131 continuing care locations, the second largest PACE program in the country, 125 urgent care locations and many other health and well-being services. Based in Livonia, Michigan, its annual operating revenue is $20.2 billion with $1.2 billion returned to its communities in the form of charity care and other community benefit programs.
