The Coding Specialist II is responsible for accurate and compliant assignment of CPT and ICD 10 codes supported by provider documentation in the medical record utilizing the current year International Classification of Diseases Manual (ICD-10) and the current year American Medical Association’s Current Procedural Terminology manual (CPT) ensuring optimal reimbursement.
Commits to the mission, vision, beliefs and consistently demonstrates our core values.
Adheres to all relevant Bryan Health/Bryan Heart policies and procedures.
Accurately assigns and sequences diagnosis and procedure codes to arrive at the correct Ambulatory Payment Classification assignment-utilizing provider supporting documentation.
Maintains coding certification by performing continuing educational requirements as defined by certifying body/organization.
Maintains thorough understanding of Government and commercial payer documentation, coding and reimbursement guidelines, CCI edits, MUE’s, NCD’s and LCD’s.
Achieves and consistently maintains departmental productivity/performance goals and metrics.
Complies with Bryan Heart Coder Audit/Competency Program.
Analyzes, researches and performs payer follow up tasks specific to coding denials (including but not limited to bundling/medical necessity/non-adherence to payer coding and reimbursement guidelines).
Assists with monitoring payer denial trends and development of denials management process.
Regularly advises direct report supervisor/director of concerns including but not limited to provider documentation content and timeliness to complete, payer performance, system functionality and any other identifiable barriers to performance thus negatively influencing the organizational goals and metrics.
Provides timely feedback to providers when identifying documentation concerns or inaccurate assignment of procedure codes.
Actively participates in meetings to build a cohesive team by responding to inquiries, making recommendations, sharing observations and respecting team members input.
Assists as requested with auditing activities.
Reviews and reports new, deleted, or inactivated procedure codes to appropriate team members.
Participates and completes mandatory annual training as assigned by Bryan Heart/Bryan Health.
Develops and fosters relationships with providers and clinical support staff.
High school diploma or equivalency required. Certification as a Certified Coding Associate (CCA) required. Certification as a Certified Coding Specialist (CCS or CCS-P) or Certified Professional Coder (CPC) preferred. Minimum of 5 years coding experience in a medical environment required. Cardiology/Cardiothoracic/Vascular coding experience preferred.
Internal Number: 16551
About Bryan Heart
We’re a Nebraska governed, nonprofit health system that cares for patients, educates tomorrow’s health care providers and motivates our community with fitness and health programs. Our award-winning network of doctors, hospitals and medical providers offers effective care; works with industry leaders to introduce leading-edge, proven treatments to our region; and serves rural communities through outreach clinics, mobile services and telemedicine care. We’re always focused on providing the personalized care and programs that make a difference in your life.