Job Details

Requisition ID

41506

Department

Coding Services

Location

Union

Not Applicable

Salary Range

24.08 - 33.71

Job Type

Full-Time

Shift

Day

Hours Per Shift

8

Hours Per Pay Period

80

Description

Job Summary

Under general supervision, the Coding Specialist is responsible for proper application of coding guidelines and principles for primary care and specialty physicians. Reviews documentation and enters appropriate CPT/ICD-10 codes, assess accuracy, and ensures optimal reimbursement. Additional duties include but are not limited to insurance verification, code reviews, and auditing accounts.

Processes incoming pending charges/superbills and office charges within 48 hours and communicates possible problems to departments and business office manager. Processes surgery charges within 72 hours from receipt. Understands and adheres to the insurance carrier's claim submission and appeal process. Makes necessary corrections to patient accounts and charges for accurate electronic submission. Prioritizes daily workload to best increase reimbursement and decrease A/R days. Reviews and corrects any errors or missing information on electronic claims; attaches necessary documentation for payment if required. Keeps abreast of coding and reimbursement changes. Demonstrates and promotes a spirit of teamwork and cooperation. Uses initiative to improve skills, learn new skills, enhance knowledge, and improve communications. Tracks and reports ongoing issues with coding and documentation as discovered. Supports Coding Specialist II with more basic specialty coding as required.

Ability to speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, PowerPoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop-down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the first two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health Medical Group rules, policies, procedures, applicable laws, and standards. Carries out the mission, vision, and quality commitment of Palomar Health Medical Group.

Job Requirements

Minimum Education: High School Diploma or equivalent

Preferred Education: College level courses or Associates degree

Minimum Experience: 2 years (non-specialty) coding experience, including abstracting, in outpatient setting

Preferred Experience: Not Applicable

Required License: Not Applicable

Preferred License: Not Applicable

Required Certification (CPC) Certified Professional Coder certification
Preferred Certification: Not Applicable

We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.