Coding Specialist (Must be CCS or CPC certified!!)

Columbus, Ohio - Full time opportunities
Chicago, Illinois - Contract opportunities


Job Description

The Coding Specialist performs reviews/audits medical information to identify coding issues and validates DRG assignment for MCO service line.

Essential Functions:

Reviews medical information to collect data, ensure appropriate billing/coding of data and follow up on questions or concerns raised by nurse and physician reviewers or health care providers.
Audits medical records for coding/billing issues and validates DRG assignment.
Applies knowledge of Medicare/Medicaid rules and regulations pertaining to appropriate billing and coding of Medicare or Medicaid accounts.
Assists with project development by serving on project teams as requested. Assists with project data analysis, reporting, and feedback. Offers quality improvement suggestions on project protocols and processes.
Identifies and coordinates routine contract deliverables to include producing and performing quality assurance on existing client reports and contact logs and all other reports requested by internal and external customers.
Enters findings into customized software application
Participates in special projects as needed related to special investigation unit work.

Requirements

CCS, CPC licensed/accredited health care professional specific to scope of contract with minimum 3 years inpatient clinical coding experience; or equivalent combination of education and experience.
Outpatient coding experience a plus
Demonstrated experience with DRG, APG, or other prospective reimbursement systems.
Demonstrated experienced in ICD-9-CM and CPT coding for the clinical area under evaluation for the specific contract to which position is assigned.
Demonstrated ability to analyze and evaluate medical information necessary to evaluate and collect specific health care information.
Demonstrated experience in medical review, chart audits, and quality improvement processes a plus.
Ability to work in a fast paced environment
Flexible to changing deadlines and priorities
Intermediate computer skills

**All qualified candidates please contact: stevepio@endevis.com