Medical Billing Specialist/Coder, Business Office, Downtown Nashville

Medical Billing Specialist/Coder, Business Office, Downtown NashvilleMidtown Plaza (PLZ) - Nashville, TN 37203OverviewPosition Type Full Time Job Shift Day Category FinanceDescriptionSUMMARY: The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice.ESSENTIAL DUTIES AND RESPONSIBILITIES:Reviews daily charges from the electronic health record to ensure coding and billing guidelines are followedUtilizes CPT, ICD-10CM, and HCPCS coding and modifier usage during daily reviewsUtilizes various coding and billing references to resolve complex billing scenariosEnsures progress notes are coded accurately and to the highest level of specificityMaintains strong knowledge of payer billing guidelines and policiesResearches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepanciesTimely alert any identified issues and/or risk that may require further researchFulfill month end requirements ensuring all charges captureAbility to meet deadlines and prioritize responsibilitiesSecondary Responsibilities:Maintains strong knowledge of both local and national CMS policies, as well as various private-payer coding and billing guidelines.Utilizes the Correct Coding Initiative Edit List (CCI) when billing for multiple services during the same encounter and understands how to correctly apply Modifiers.Informs Patient Accounts Department when additional account balance reviews are needed.Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies.Utilizes various coding and billing references to resolve complex billing scenarios.Consistently follows internal coding and billing protocols and policies.Demonstrates a commitment to expand coding & billing knowledge by participating in various continuing education opportunities each year.Demonstrates a positive willingness to take on additional assignments and responsibilities.Must maintain professional and courteous relationships with all team members at all times.Must have predictable and consistent attendance and follow all attendance policies.Skills/Qualifications:Active Certified Coder License CPD, CCS). Required experience in OB/GYN. Epic experience is desirable.QualificationsCERTIFICATES, LICENSES, AND REGISTRATIONSActive Certified Coder License preferred (CPC, CCS)EDUCATION and/or EXPERIENCEHigh school diploma requiredOB/GYN Coding Experience Preferred5+ years of Charge Entry or Medical Billing experience requiredMulti-Specialty physician coding experience preferredCompletion of an accredited Medical Coding/Billing Program preferredMust have knowledge of CPT and ICD10Experience with EPIC EMR System and Electronic Charge Capture preferredAdvanced knowledge of CPT, ICD-10CM, HCPCS coding and of Modifier usage for multiple specialtiesKnowledge of CMS billing and documentation guidelines and CCI Edit ListsAdvanced understanding of medical documentation requirements for E/M coding and office proceduresAbility to abstract key information from the medical record to ensure accurate codingEffective communication skills, to explain guidelines to new employees in an easy to understand mannerExcellent computer skills, including advanced typing speed, ten-key and mouse click selection skillsAbility to easily and quickly maneuver through various computer software programs such as MS Outlook, Word, Excel, electronic health records, patient billing systems, and other medical information software systemsExceptional attention to detail and the ability to quickly identify discrepancies or uncommon billing situationsStrong judgment skills and ability to work through complex matters independentlyExcellent time management and organizational skillsAbility to prioritize work responsibilities and complete assignments in a timely fashionStrong initiative to anticipate departmental needs and work supportively to respond to such needs.Ability to work effectively and cooperatively with all levels of management, physicians, team colleagues, and other departments.Must be able to sit for long periods of timeRequires moderate walking, bending, pushing, pulling, twisting and liftingMental alertnessHigh volume, faced paced office environment with a strong commitment to timeliness and organizationOffice environment-limited exposure to communicable diseases.No exposure to blood-borne pathogens or contaminated body fluids