Saint Francis
ProFeeCodingSpecialist
Neural analysis suggests this role is
optimal for Entry candidates.
“Pro Fee Coding Specialist at Saint Francis. Skills: diagnosis and procedure codes, medical record documentation review, coding and billing requirements, communication skills, interpersonal skills, organizational skills, multitasking skills. reviews documentation and reviews, adds or corrects diagnosis and procedure codes that have been submitted by the provider. Codes as assigned from review of medical record documentation”
What You'll Achieve.
ensure claims are submitted correctly; resolve denials related to coding errors; resolution of coding denials; assure compliance with local, state and national policies; ensure accurate coding
Industry & Context.
Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field; Ability to determine whether a record is complete enough to code or should be held for more documentation
What They're Looking For.
Must Have
GED or High School diploma, Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Association of Professional Coders (AAPC), Board Certified Home Health Coding Credentialing (BCHH-C) – WellSky, Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA), Hierarchical Conditions Categories (HCCS) from The Compliance Certification Board (CCB), obtain the certification within one year of hire if they do not have a required certification
Nice to Have
Experience and/or training in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded, 2 years related experience
What You'll Do.
reviews documentation and reviews
adds or corrects diagnosis and procedure codes that have been submitted by the provider
Codes as assigned from review of medical record documentation
Applies knowledge of current coding and billing requirements to ensure claims are submitted correctly
Monitors coding and billing performance and resolves denials related to coding errors
Performs review for charge corrections and rebilling as required for resolution of coding denials
prepares periodic reports for clinical staff
identifying corrective measures to resolve denial problems
Advises and instructs providers regarding documentation and billing policies
procedures and interacts with providers regarding conflicting
ambiguous or none-specific documentation
obtaining clarification of the same
Educates providers and office staff regarding documentation coding and billing changes and regulations to assure compliance with local
state and national policies
Stays updated on coding rules
attends seminars and reviews and coding periodicals
How You'll Work.
Team & Collaboration
Works collaboratively with providers, office staff, billing personnel, quality department and compliance, and coding resources to ensure accurate coding; Works with other healthcare professionals and staff; Works directly with patients and/or customers; Works with internal and/or external customers via telephone or face to face interaction
Communication Scope
Excellent communication skills, both written and verbal that present clear and concise information
Full Job Description
**Current Saint Francis Employees - Please click[HERE](http://www.myworkday.com/saintfrancis/d/task/3005$4482.htmld) ****to login and apply.** This position is ECB status – requires a minimum number of worked hours per month as needed by the department; limited benefit offerings. Job Summary: The Pro Fee Coding Specialist reviews documentation and reviews, adds or corrects diagnosis and procedure codes that have been submitted by the provider. This role utilizes coding knowledge learned through valid coding resources in decision making. Minimum Education: GED or High School diploma. Licensure, Registration and/or Certification: (CCS) Certified Coding Specialist - American Health Information Management Association (AHIMA), (CPC) Certified Professional Coder - American Association of Professional Coders (AAPC), (BCHH-C) Board Certified Home Health Coding Credentialing – WellSky, (RHIA) Registered Health Information Administrator - American Health Information Management Association (AHIMA), (RHIT) Registered Health Information Technician - American Health Information Management Association (AHIMA), or Hierarchical Conditions Categories (HCCS) from The Compliance Certification Board (CCB). The applicant will need to obtain the certification within one year of hire if they do not have a required certification. Work Experience: None. Experience and/or training in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded, preferred. 2 years related experience, preferred. Knowledge, Skills, and Abilities: Sound knowledge and understanding of the content of the medical record in order to be able to locate information to support or provide specificity for coding. Basic encoder skills. Knowledge of Microsoft 365 and other applicable software. Excellent communication skills, both written and verbal that present
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