Coding Operations Coordinator

Job Description

Description:

The Coding Operations Coordinator is responsible for assisting the Coding Manager with daily oversight of the coding teams. The coordinator researches, resolves, and submits claims and takes timely and routine action to assist team members in resolving complex coding cases and denials and ensures timely completion of coder work assignments and claims submission. Codes diagnoses, and procedures of physician services in accordance with CMS requirements, official coding guidelines, government regulations and internal policies. Requirements:

ESSENTIAL DUTIES AND RESPONSIBILITIES (Other duties may be assigned)

As a key member of the Coding team the Coding Operations Coordinator:

Monitors work queues and assigns tasks to coders to ensure timely completion and submission of claims.

Performs second level reviews on accounts that are sent back for coding edits.

Assists coding manager in distributing and reviewing audit results.

Provides coders with education and guidance on correct coding based on second level reviews and quality audits.

Assists coding manager and coding department with questions, coding reviews, and other coding inquiries.

Assists other departments within the organization with coding questions, reviews, or inquiries.

Codes accounts when coverage is needed.

Understands, interprets, and applies coding guidelines for coding.

Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding.

Completes online education courses and attends mandatory coding workshops and/or seminars ICD-10 and CPT updates) for Physician Services coding. Reviews AHA and CPT quarterly coding update publications.

Must meet coding accuracy requirements.

Reviews and prepares response to external payer and compliance audits, including but not limited to RAC, payer audits, and external compliance audits.

QUALIFICATIONS

EDUCATION AND EXPERIENCE

2+ years orthopedic surgery and/or Evaluation and Management (E/M) coding experience required. Other surgical specialties considered.

Must have current CPC, CPMA, COSC or CEMC certification from AAPC. Will consider CCS-P or CCS certification from AHIMA, with relevant work experience.

Proficiency in MS Office products - intermediate to advanced knowledge of MS Excel.

SKILLS/ABILITIES

Must successfully pass pre-hire coding assessment.

Strong technical knowledge of Centers for Medicare & Medicaid Services (CMS) regulatory guidelines, including ICD-10 CM, CPT, and HCPCS Procedure Coding, and official coding guidelines.

Knowledge of disease pathophysiology and drug utilization.

Knowledge of NCCI edits structures.

Must be detail oriented and have the ability to work independently.

Computer knowledge of MS Office, including Word and Excel.

Must display excellent interpersonal skills.

Ability to demonstrate initiative and discipline in time management and assignment completion.

Ability to work in a virtual setting under minimal supervision.

PHYSICAL DEMANDS

While performing the duties of this job, employee is regularly required to sit, stand, walk, reach with hands and arms, and to talk and hear. Employee may be occasionally required to climb or balance, stoop, kneel, or crouch. Employee must occasionally lift, push and/or move up to 30 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

WORK ENVIORNMENT

Work may be fast-paced and intense at times. Interaction with others is constant and interruptions may occur. Schedule requires flexibility to occasionally include evenings, early mornings, and weekends.

The above describes the general content of and requirements for the performance of this position. It is not intended to be an all-inclusive statement of the duties, responsibilities, and requirements of the position.