The Coding Specialist will assure consistent quality coding in evaluation management, office procedures, and surgical coding while adhering to applicable federal, state, local, and department requirements.

This is a full-time position working Monday through Friday; flexible between 8am to 5pm at our Golden Valley Business Office.

Essential Functions:

• Assign appropriate ICD-10-CM codes, per provider documentation using the most current diagnosis set
• Assign appropriate CPT and HCPCS codes, per provider documentation, for hospital and clinic procedures
• Review operative reports to assign appropriate CPT surgical codes
• Investigate discrepancies in documentation
• Follow coding policies and guidelines to determine appropriate coding
• Provide education and feedback to providers regarding documentation and billing processes
• Manage and provide coding support for coding backlogs, staffing coverage, and taking ownership of workloads
• Review denied claims to determine appropriate action for appeals
• Respond to pre-certification requests and estimate requests
• Monitor all “unkeyed” encounters to ensure that all billable services have been captured
• Research technical questions and in coordination with Coding Manager, determine written policies
• Any and all other duties as assigned

Education and Experience Requirements:

• High School diploma/GED or equivalent
• Coding Certification (CPC, CCS-P, RHIT or RHIA) and/or minimum of (5) years’ experience in related field preferred
• Intermediate knowledge of ICD-10-CM, CPT, HCPCS and payer specific guidelines
• Intermediate understanding of medical terminology, body system/anatomy, physiology and concepts of disease processes
• At least 1 year of Ortho surgery experience

Essential Requirements:

Ability to:

• Comply with company policies, procedures, practices and business ethics guidelines.
• Complete job required training.
• Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
• Demonstrate prompt and reliable attendance
• Work in the office during business hours
• Travel independently throughout the office (which may include movement from floor to floor); frequent bending, lifting, standing, stooping or sitting for long periods of time may be required
• Work at an efficient and productive pace, handle interruptions appropriately and meet deadlines
• Communicate and interact in a respectful and professional manner
• Prioritize workload while being flexible to meet the expectations of the daily operations
• Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions
• Understand and execute a variety of instructions
• Effectively operate equipment and communicate on and operate the phone system
• Work independently with minimal supervision
• Travel to other work locations, if required

Performance Expectations – Revo Health’s Core Values:

• Integrity - Do the right thing and take responsibility for what you do and say
• Service - Consistently contribute to deliver an exceptional experience
• Quality - Act with high purpose, committed effort, and skillful execution to exceed expectations
• Innovation - Identify progressive solutions that improve service, teamwork, efficiency, and/or effectiveness
• Teamwork - Be a part of the whole; support each other positively

Environmental Conditions:

• Office setting

Notes

• Revo Health is a management services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed through Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions.
• Revo Health is an Equal Opportunity/Affirmative Action Employer and will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008.
• This position description will be reviewed periodically as duties and responsibilities change. Essential and Additional Job Functions are subject to modification.