Coding Spec I MPBS

MedStar Health


Date: Sep 23, 2022
City: Baltimore, MD
Contract type: Full time
MedStar Health
Job Summary

Ensures that MedStar Health’s medical-professional services are coded correctly and completely, based upon extensive, complete, up-to-date knowledge of regulatory and specific payer requirements. Recommends policy and a procedural change to obtain optimum reimbursement for services rendered. In addition to interacting with physicians on coding issues, ensures that physician encounter forms, the GE IDX billing system and MPBS processes are up to date and compliant regarding coding issues. Assists manager as required.

Minimum Qualifications

Education/Training

High School graduation or equivalent. Bachelors Degree Preferred. Consideration will be given to appropriate combination of education, training, and experience.

Experience

2 years medical-professional coding experience with demonstrated ability to work independently.

License/Certification/Registration

Certified Professional Coder (CPC) certification from AAPC is required.

Knowledge, Skills & Abilities

Attention to detail accompanied by outstanding organizational skills. Ability to interact effectively with physicians, liaisons, department administrators and associates. Ability to work independently and practice self-direction. Ability to communicate and deal with physicians in a professional, articulate manner and understand medical terminology specific to body systems. In-depth knowledge of billing process, including, but not limited to, claims submission, whether manual or electronic, different payer requirements re: modifiers and correct diagnosis/procedure linkage. Broad, deep medical knowledge, including but not limited to: extensive knowledge of medical terminology, knowledge of human anatomical systems/body systems, and knowledge of medical procedures performed by physicians, nurses and allied health workers. Working knowledge of payer policies, HCFA policies, local and national regulatory and compliance policy, knowledge of all available coding resources.

Primary Duties and Responsibilities

Abstracts and ensures accuracy of diagnosis, procedure, patient demographics, and other required data elements.

Accesses and understands coding software used by hospital coders, as a verification/cross check tool to ensure that technical component coding done by hospital coders and professional component coding is synchronized correctly on accounts involving both billing components (example: Radiology coding).

Aids in the creation of training and educational coding guidance documents for physicians and MPBS Associates.

Assists in the maintenance of billing, coding and edit dictionaries in the billing system.

Consistently meets or exceeds established Quality, Accuracy, and Productivity standards as defined by policies.

Contacts physician when conflicting or ambiguous information appears in the medical record; requests diagnosis from physicians when not recorded in medical records.

Determines the sequence of diagnoses for accurate claims submission.

Employs knowledge of coding compliance, directs efforts to achieve quality standards identified through coding reviews or targeted by management for improvement.

Identifies and reports issues and trends in physician documentation and/or work routed to Coding from other departments.

Maintains continuing education and credentials as required for job classification.

Recommends policy and procedural changes and improvements for revenue enhancement.

Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.

Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.

Performs other duties as assigned. About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.

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