Full-Time Anesthesia Coding Specialist II

Coding Specialist II Overview:

The Coding Specialist II adheres to NM's mission, vision, values, Code of Ethics and Corporate Compliance Program, and relevant policies, procedures, guidelines, and regulatory/accreditation standards.

Essential Skills:

• Anesthesia Coding Experience: Crucial for this role.
• CPT and ICD-10 Coding Expertise: Must be proficient in coding through medical record abstraction, focusing on complex encounters.
• HCPCS Procedural Code Proficiency: Ideal if you have experience with HCPCS codes.
• Medical Record Review: Thorough review of available medical records.
• Coding Accuracy: Aiming for 95% accuracy in coding assignments.
• Physician Training & Support: Providing training to physicians on documentation, billing, and coding.
• Optum Coding Edits: Demonstrating expertise in resolving Optum coding edits.
• Claims Resolution: Proficient in resolving incorrect claim issues.

Responsibilities:

• Reviews medical records thoroughly and codes physician services and diagnoses (including anesthesia, OR, surgical procedures, invasive procedures, drug infusions, E&M services, bedside procedures, and diagnostic tests).
• Assigns CPT, ICD-10 codes, and modifiers with 95% accuracy, following official guidelines.
• Ensures charge capture by performing various reconciliations (e.g., procedure schedules, OR logs, clinical system reports).
• Provides feedback to physicians on documentation.
• Trains physicians and staff on documentation, billing, and coding.
• Reviews and communicates new/revised guidelines.
• Attends meetings and educational roundtables; communicates information to staff and physicians.
• Resolves pre-accounts receivable edits.
• Identifies documentation issues and system issues.
• Corrects incorrect billing, adds missing services, and provides missing data; corrects CPT, ICD-9 codes, and modifiers.
• Collaborates with Patient Accounting, PB Billing, and other operational areas.
• Acts as a point person for Revenue Cycle and Account Inquiry Unit.
• Provides code and modifier information for appeal purposes; may contact providers for reviews.
• Meets productivity and quality standards.

Qualifications:

• RHIA, RHIT, or CPC/CCS certification.
• 0-2 years of relevant experience.
• 94% accuracy on the organization's coding test.

Preferred Qualifications:

• Bachelor's or Associate's degree in Health Information Management (CAHIIM accredited).
• Previous physician coding experience.

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