Pro Fee Coding Spec
5 days ago
OverviewKettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio.
We are committed to transforming the health care experience with high-quality care for every stage of life.
Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.Responsibilities & RequirementsThis position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation.KPN Pro Fee Coding SpecialistServes as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI editsAccurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements (CMS LDC/NCD and/or payer policy)Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI editsCorresponds with providers on pending claims to facilitate resolutionResponsible for participating in departmental goals, KHN mission and implemented KHN/KPN policiesCommunicate appropriately with providers, leaders, and staffResearches and resolves concerns timelyEducational Requirements:High School Diploma or equivalentRHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certificationPrior experience in professional fee coding/billingKnowledge and Skill:CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI EditsMedical Terminology and Anatomy & PhysiologyComputer and EPIC ApplicationsExcellent verbal and written communication skillsAbilities:Charge Review WQ (Edits)Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.Claim Edit WQ (Edits)Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.Follow Up WQ (Denials)Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.Departmental ResponsibilitiesResponsible for participating in departmental goals, KHN mission and implemented KHN/KPN policiesDemonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI editsFollow procedures pertaining to positionResearches and resolves concerns timely
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Pro Fee Coding Spec
5 days ago
Auckland, Auckland, New Zealand Kettering Health Network Full timeOverviewKettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio.We are committed to transforming the health care experience with high-quality care for every stage of life.Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the...
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Pro Fee Coding Analyst
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Auckland, Auckland, New Zealand Kettering Health Network Full timeAbout the RoleReviews and interprets physician documentation to assign accurate evaluation and management codes.Applies correct modifiers and identifies global services based on coding guidelines.Corrects assigned codes to ensure consistency with ICD-10 CM Official Guidelines, CPT, and CMS.RequirementsOne of the following certifications: RHIA, RHIT, CCS-P,...
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Pro Fee Coding Consultant
4 days ago
Auckland, Auckland, New Zealand Kettering Health Network Full timeCoding compliance and EPIC WQ reconciliationSubject matter expert on CMS billing rules and regulationsResponsible for participating in departmental goals, KHN mission, and implemented KHN/KPN policies
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Medical Coding Specialist
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Auckland, Auckland, New Zealand Kettering Health Network Full timeJob Summary: The Pro Fee Coding Specialist at Kettering Health Network reviews, interprets, and verifies evaluation and management codes according to physician documentation. This role requires advanced knowledge of ICD-10 CM coding guidelines, CPT, and Evaluation and Management Coding and Documentation Guidelines.
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Coding Compliance Expert
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Auckland, Auckland, New Zealand Kettering Health Network Full timeAbout the RoleWe are seeking an experienced Professional Fee Coding Specialist to join our team. As a subject matter expert, you will ensure coding compliance and knowledge of CMS billing rules and regulations. You will serve as a professional fee coding resource to network service lines, demonstrating expertise in CPT, HCPCS, ICD-10, and CMS NCCI edits.
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Professional Fee Coding Specialist
5 days ago
Auckland, Auckland, New Zealand Kettering Health Network Full timeCompany OverviewKettering Health Network is a not-for-profit healthcare system serving southwest Ohio. Our mission is to provide high-quality care for every stage of life, with a commitment to transforming the healthcare experience.
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