Coding Specialist
Family Health Centers of Southwest Florida, Fort Myers, FL, United States
Position Description
Responsible for the accurate and efficient coding of FHC medical records in compliance with all legal regulations and accepted standards. The Coder reviews charts as assigned by the Coding Supervisor, scans them for errors and omissions, makes edits as necessary, and submits them for processing.
Detailed Duties and Responsibilities
Review accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
Audit clinical documentation and coded data to validate that documentation supports diagnoses, procedures, and all services rendered for reimbursement and reporting purposes.
Identify diagnostic and procedural information and review physician pending charges for appropriate complexity using CPT coding guidelines.
Assign codes for reimbursements and compliance with regulatory requirements utilizing guidelines and following up-to-date coding conventions.
Work closely with the Coding Supervisor to provide feedback to providers to improve documentation practices.
Confirm patient demographic, insurance, and referring physician information is accurately entered in Intergy.
Enter all codes, CPT, HCPCS, and ICD-10 coding and modifiers in Intergy timely and accurately.
Follow established checks and balances systems to ensure complete and accurate code capture.
Review Medicare Local Coverage Determinations (LCDs), Medicare bulletin updates, and Medicare NCCI.
Serve as coding consultant to providers.
Keep abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and third‑party payers.
Keep abreast of standard coding guidelines (including Medicare, Medicaid, Managed Care, HEDIS, and FQHC guidelines).
Provide updates and status reports to management weekly.
Other duties as assigned.
Requirements Knowledge
Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment.
Medical terminology, CPT, HCPCS, and ICD-10 coding and modifier usage required.
Understanding of FQHC billing procedures and Sliding Fee Schedules a plus.
Understand and adhere to all HIPAA guidelines.
Skills and Abilities
Medical Coding & Billing course completion preferred.
2 years Medical Coding experience preferred.
Certified Professional Coder (CPC) Certification preferred.
Minimum 1-year employment in a healthcare-related field.
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Detailed Duties and Responsibilities
Review accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
Audit clinical documentation and coded data to validate that documentation supports diagnoses, procedures, and all services rendered for reimbursement and reporting purposes.
Identify diagnostic and procedural information and review physician pending charges for appropriate complexity using CPT coding guidelines.
Assign codes for reimbursements and compliance with regulatory requirements utilizing guidelines and following up-to-date coding conventions.
Work closely with the Coding Supervisor to provide feedback to providers to improve documentation practices.
Confirm patient demographic, insurance, and referring physician information is accurately entered in Intergy.
Enter all codes, CPT, HCPCS, and ICD-10 coding and modifiers in Intergy timely and accurately.
Follow established checks and balances systems to ensure complete and accurate code capture.
Review Medicare Local Coverage Determinations (LCDs), Medicare bulletin updates, and Medicare NCCI.
Serve as coding consultant to providers.
Keep abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and third‑party payers.
Keep abreast of standard coding guidelines (including Medicare, Medicaid, Managed Care, HEDIS, and FQHC guidelines).
Provide updates and status reports to management weekly.
Other duties as assigned.
Requirements Knowledge
Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment.
Medical terminology, CPT, HCPCS, and ICD-10 coding and modifier usage required.
Understanding of FQHC billing procedures and Sliding Fee Schedules a plus.
Understand and adhere to all HIPAA guidelines.
Skills and Abilities
Medical Coding & Billing course completion preferred.
2 years Medical Coding experience preferred.
Certified Professional Coder (CPC) Certification preferred.
Minimum 1-year employment in a healthcare-related field.
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