• Coding Specialist (Pro-fee)

    Job ID
    2018-24571
    Employment Type
    full-time
    Hours Per Week
    40
    Onsite Work Schedule Details
    M-F 8-4:30AM
    City
    Remote
  • Overview

    The Coding Specialist will work closely with HIM and other support departments to reimburse healthcare claims. This individual will utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing as well as review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place before submission. 

    Responsibilities

    • Selects and sequences ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but are not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management.
    • Reviews and analyzes clinical records to ensure that APC assignments accurately reflect the diagnoses/procedures documented in the clinical record.
    • Abstracts clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
    • May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
    • Maintains strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release of information.
    • Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
    • Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
    • Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to nThrive’s business practices. This includes: becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

    Qualifications

    • Active RHIA, RHIT, CCS
    • 3+ years of recent and relevant hands-on coding experience including active production coding
    • Ability to consistently code at 95% threshold for both accuracy and quality while maintaining client-specific and nThrive production standards
    • Proficient computer knowledge including MS Office (Outlook, Word, Excel, Power Point)
    • Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers
    • Candidates must successfully pass pre-employment coding test
    • Cable or DSL high-speed, wired Internet Connection

    About nThrive

    Be Inspired. Ignite Change. Transform Health Care.
    From Patient-to-Payment, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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