Coding analyst

Position: Coding Analyst Responsibilities - Provide second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices - Audit medical record documentation to identify under-coded and over-coded services; prepare reports of findings and meet with providers to provide education and training on accurate coding practices and compliance issues - Interact with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specific documentation through provider queries - Submit any issues or trends found within documentation by a physician and/or physician extender to Revenue Cycle Manager and/or practice administrator - Interact with Revenue Specialists and practice billing specialists to ensure appropriate and complete follow-up of patient accounts to maximize reimbursement through AR management processes, including corrections and resubmissions as needed - Analyze individual payor performances regarding fee schedule reimbursements and trends - Research, analyze, and respond to inquiries regarding compliance, payor policies and guidelines, inappropriate coding, denials, and billable services - Monitor and distribute communications regarding payor policy changes and updates, in relation to our provider specialties - Provide training, guidance and oversight to staff less experienced in coding guidelines - Serve as an information resource and guide to clinicians, champion the need to change coding behaviors, and serve as subject matter expert - Train, instruct, and provide support to medical providers and practice billing specialists as appropriate regarding coding compliance, documentation, regulatory provisions, and third-party payor requirements - Review, develop, modify, and adapt relevant client procedures, protocols, and data management systems to ensure compliance with organization’s policies - Interact with providers and management to review and/or implement codes and to update charge documents - Illustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, claims, and state insurance laws - Ensure strict confidentiality of financial and medical records - Perform miscellaneous job-related duties as assigned ### Qualifications - Certified Professional Coder (CPC) certification required - Minimum of 5 years’ experience as a biller, collector, coder, or back office support staff, or other equivalent medical industry experience - OB/GYN experience