The Coding Reimbursement Specialist II is responsible for accurately interpreting and billing physician charges by entering the appropriate CPT, ICD-10, and modifier codes into the billing system.
This is a full-time hybrid or remote position supporting the RCM team, Monday through Friday, 8:00 AM to 5:00 PM.
Key responsibilities include:
- Performing initial charge reviews to determine appropriate ICD-10 and CPT codes for physician services
- Interpreting progress notes, operative reports, discharge summaries, and charge documents to identify services provided and assign accurate codes
- Entering codes, diagnoses, and modifiers into the TMP billing system to complete the charge process
- Ensuring charges are processed within department timeliness standards and communicating with team members and practice management as needed
- Contacting physicians through query protocols regarding procedures and other billed services to ensure proper coding
- Reviewing patient logs and other clinical activity reports to ensure all billable services are captured
- Reviewing physician documentation for compliance with third-party and regulatory guidelines
- Working with reimbursement staff to respond to coding and billing inquiries for TMP physicians' services
- Performing other related duties as assigned
Requirements & Qualifications
Education and Certifications
- High school diploma or GED required
- Minimum of 3 years of experience with CPT and ICD-10 coding of physician services required
- Coding certification required; CPC certification preferred
- Active certification and required CEUs must be maintained during employment
- Advanced knowledge of medical terminology, anatomy, and physiology required
- Ability to apply payer-specific rules related to coding, bundling, and modifiers
- Understanding of regulatory guidelines, including NCDs and LCDs
Experience and Skills
- Experience in Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, or Dermatology preferred
- Knowledge of third-party billing and collection regulatory guidelines and requirements
- Advanced knowledge of ICD-10-CM/PCS and CPT/HCPCS coding systems and conventions
- Advanced knowledge of Official Coding Guidelines and methodologies
- Strong interpersonal skills and ability to work in a team environment
- Ability to gather and interpret clinical data
- Ability to work independently in a fast-paced environment
Physical Requirements
- Ability to walk, stand, sit, lift, reach, stoop, bend, push, and pull as needed
- Must be able to lift and support up to 35 pounds
- Ability to concentrate on details
- Ability to use a computer for extended periods
Location
Charlotte, North Carolina, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 week ago