Certified Medical Coding Specialist
Remote, | Medical Coding
Position Summary:Must reside in NC, SC, GA, NY, CA, OR, WA, MO, OK, NC DE, CT
GoHealth Urgent Care was founded in 2013 on the philosophy that people deserve the highest-quality patient experience in a walk-in care environment, GoHealth Urgent Care has grown to more than 145 state-of-the-art urgent care centers in just a few years, and we continue to expand rapidly.
This is not an entry level position. Must have a minimum of 2 years EM/Clinical Procedural coding experience and be able to pass an EM assessment.
Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Accurately codes office procedures for providers to ensure proper reimbursement. Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD-9-CDM and ICD-10-CDM, HCPCS and CPT codes. The Certified Coding Specialist is responsible for abstraction and accurate coding of procedures from the medical record to ensure optimal reimbursement while staying compliant with OIG, CMS, the local Medicare Administrative Contractor, all system policies and procedures and any state and other regulatory agencies.
The Certified Coding Specialist must adhere to all CPT guidelines and ICD-9/10 Coding Guidelines.
- Audits records to ensure proper submission of services prior to billing on pre-determined selected charges
- Supplies correct ICD-9-CM /ICD-10-CM diagnosis codes on all diagnoses provided
- Supplies correct HCPCS code on all procedures and services performed
- Supplies correct CPT code on all procedures and services performed
- Contacts providers to train and update them with correct coding information
- Attends seminars and in-services as required to remain current on coding issues
- Audits medical records to ensure proper coding completed and to ensure compliance with federal and state regulatory bodies
- Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
- Maintains all mandatory in-services
- Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct. Reports compliance problems appropriately.
- Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.
- Quantitative analysis - Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
- Qualitative analysis - Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
- Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code
- Performs other related duties, which may be inclusive, but not listed in the job description
All qualified persons are granted an equal opportunity for employment without regard to race, color, religion, sex, sexual orientation and gender identity or expression, age, national origin, citizenship status, disability, genetic information, medical condition, family care leave status, pregnancy or pregnancy-related condition, otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.
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GoHealth Urgent Care has outstanding career opportunities in Connecticut, Delaware, Missouri, New York City, North Carolina, Northwest Arkansas, Oklahoma City, San Francisco and the Portland-Vancouver area. And all of these positions have one thing in common: flexibility to practice urgent care medicine the way it was meant to be, without the stress and bureaucracy of hierarchical organizations. With reasonable work hours that don’t emotionally exhaust them or burn them out, our team can balance and prioritize their professional and personal lives.