Job Details

Overview

Coding Senior Specialist/Full Time/Remote-Michigan Residents Only

Resolve complex accounts, acting as a subject matter resource for his/her functional area, educating team members on account resolution workflows, and assisting the supervisor with escalated issues. The CBO Coding Senior Specialist confirms the accuracy and completeness of coding to ensure compliant claims are sent to payers. The CBO Coding Senior Specialist works independently to resolve complex diagnostic accounts. The CBO Coding Senior Specialist helps drive change by identifying areas where performance improvement is needed (for example; day-to-day workflow, education, process improvements, patient satisfaction). The CBO Coding Senior Specialist performs quality validation of information as well as continuous education and opportunity feedback to a multi-disciplinary team with the objective of sending out clean quality claims and working and preventing denials.

Responsibilities

• Resolve complex accounts; educate team members on account resolution workflows.
• Assist supervisor with escalated issues and ensure accuracy and completeness of coding for compliant payer submissions.
• Work independently to resolve complex diagnostic accounts.
• Identify areas for performance improvement (e.g., workflow, education, process improvements, patient satisfaction) and drive change.
• Provide quality validation of information and feedback to a multi-disciplinary team to send out clean quality claims and prevent denials.

Qualifications

• High school diploma or G.E.D. equivalent required.
• Minimum of five (5) years coding experience required.
• Minimum of five (5) years specialty coding required.
• Minimum of two (2) years of revenue cycle experience in a large healthcare system required. Additional specialty coding certification or 10 years coding experience required.
• One to two (1-2) years college or additional course work in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred.
• Knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. Strong organizational and time management skills to prioritize work.
• Effective communication with colleagues, supervisors, and managers; ability to work independently and to engage in team meetings and activities.
• Proficient in medical terminology and in ICD-10 CM, CPT and HCPCS coding.
• Able to recognize patterns and trends and escalate to supervisors to support root-cause analysis.
• Able to coach other team members with challenging accounts.
• Adheres to HFHS Code of Conduct and legal/ethical guidelines.

Certifications/Licensures

• Certification as a RHIT, CPC, or CCS required.

Additional Information

• Organization: Corporate Services
• Department: CBO Coding PB
• Shift: Day Job
• Union Code: Not Applicable

Seniority level

• Associate

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• Hospitals and Health Care, Insurance, and Wellness and Fitness Services

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