Job Description

General Summary

Collects, reviews, retrieves and codes Evaluation & Management codes, and major procedures (surgical procedures, anesthesia reports, radiology reports/procedures) and other services for Medicine/Surgical practices, based on data from medical documentation and reports for quality assessment, audit, and billing purposes.

Duties and Responsibilities

Essential Functions:

• Performs chart audits, reviewing for accuracy and compliance.
• Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) procedure codes (CPT), and other items (HCPCS) for final billing.
• Research and process invoice corrections.
• Reviews and analyzes coding/billing procedures.
• Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers.
• Coordinates and implements reimbursement improvement activities with staff and providers.
• Adheres to WellSpan Coding Compliance Guidelines

Common Expectations:

• Maintains job specific standards and expectations relative to productivity and quality.
• Prepares and maintains appropriate documentation as required.
• Maintains professional growth and development.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 1 year Relevant experience. Required

Licenses:

• Certified Professional Coder Upon Hire Required or
• Certified Coding Specialist - Physician Based Upon Hire Required or
• Certified Medical Coder Upon Hire Required or
• Certified Professional Coder Apprentice within 1 year Required or
• Certified Outpatient Coder Upon Hire Required or
• Registered Health Information Technician Upon Hire Required or
• Certified Home Care Coding Specialist - Diagnosis Upon Hire Required

Courses and Training:

• Certified Home Care Coding Specialist-Diagnosis (CHCS-D) – Only required for VNA Home Health Services. Upon Hire Required

Knowledge, Skills, and Abilities:

• Knowledge of ICD-10-CM, CPT-4, and HCPCS coding.
• Basic computer skills.

Benefits Offered:

• Comprehensive health benefits
• Retirement savings plan
• Paid time off (PTO)
• Education assistance
• Financial education and support, including DailyPay
• Expanded Paid Parental Leave

For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)