Adeptus Health Coding Specialist in Lewisville, Texas
Under the direct supervision of the SVP Sales, the Coding Specialist is responsible for the accuracy and timeliness of ensuring that all charges are coded and posted appropriately and submitted correctly to the individual insurance carriers. Obtains medical information from Facilities when required to code and post the claim(s). This is a full time, 40 hour a week position.
Responsible for coding all superbills.
Audit charge postings of coded superbills.
Identify and research claim rejection trends to identify impact on timely filing.
Assist your team members as needed.
Performs all other tasks as assigned by Assistant Billing Manager.
Coordinates and participates in the coding of pertinent medical information from a variety of complex records and billing edits to include diagnosis, treatment of illness and procedure performed while ensuring accuracy of work adherence to established coding procedure of ICD-10 (International Classification of Diseases) and CPT-4 (Current Procedural Terminology).
Submits/receives claims status through the Centricity system, researching and correcting denial claims needing further attention to resubmit as an acceptable by the insurance carriers.
Customer Service Responsibilities
Ensures each patient is given the highest level of customer service and every staff member is treated with the utmost respect.
Communicates effectively, courteous and demonstrates a caring attitude with patients, families, team members and insurance carrier representatives at all times.
Provides courteous, knowledgeable and timely service to co-workers.
Updates Centricity with new insurance and/or demographic information as needed.
Researches and answer co-worker and/or patient questions and provide follow-up communication within a timely manner.
Maintains strict confidentiality in accordance with HIPPA regulations and company policy.
Any patient private health information must not be divulged on any account except to the Patient/Guarantor’s insurance carrier that needs the information in order to process the claim for payment.
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.
Embodies the principles of the company Mission Statement and Philosophy at all times.
Represents the company in a positive fashion and makes all individuals feel as comfortable as possible.
Conducts all business in a professional manner maintaining respect for individuals at all times.
Complies with departmental and company-wide policies and procedures
Maintains constant awareness of potential safety hazards insuring necessary safety precautions.
Reads and complies with established policies and procedures including Patient Account policies containing the company designations.
At least 2 years of experience in a medical office.
CPC, CPC-H, CPC-A or CPC-H-A certified preferred, if not certified must obtain certification within 12 months of employment.
Ability to abstract ICD-10-CM and CPTs from medical records required.
Knowledge in anatomy and medical terminology required.
Ability to meet and maintain 2.5 minutes per chart with an accuracy of 90% or greater.
Must incorporate excellent customer service skills in dealing with personnel, physicians, peers and clients. Must express information in a clear, concise and organized manner.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to define problems, collect data, establish facts, and draw valid conclusions.
Must use problem solving process in making business and personnel decisions.
Proficiency in Microsoft Office
Must have excellent interpersonal skills.
Company: Adeptus Health - Corporate