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General Summary

Collects, reviews, retrieves and codes Evaluation & Management codes, and major procedures (surgical procedures, anesthesia reports, radiology reports/procedures) and other services for Medicine/Surgical practices, based on data from medical documentation and reports for quality assessment, audit, and billing purposes.

Duties and Responsibilities

Essential Functions:

+ Performs chart audits, reviewing for accuracy and compliance.

+ Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) procedure codes (CPT), and other items (HCPCS) for final billing.

+ Research and process invoice corrections.

+ Reviews and analyzes coding/billing procedures.

+ Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers.

+ Coordinates and implements reimbursement improvement activities with staff and providers.

+ Adheres to WellSpan Coding Compliance Guidelines

Common Expectations:

+ Maintains job specific standards and expectations relative to productivity and quality.

+ Prepares and maintains appropriate documentation as required.

+ Maintains professional growth and development.

+ Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

+ High School Diploma or GED Required

Work Experience:

+ 1 year Relevant experience. Required

Licenses:

+ Certified Professional Coder Upon Hire Required or

+ Certified Coding Specialist - Physician Based Upon Hire Required or

+ Certified Medical Coder Upon Hire Required or

+ Certified Professional Coder Apprentice within 1 year Required or

+ Certified Outpatient Coder Upon Hire Required or

+ Registered Health Information Technician Upon Hire Required or

+ Certified Home Care Coding Specialist - Diagnosis Upon Hire Required

Courses and Training:

+ Certified Home Care Coding Specialist-Diagnosis (CHCS-D) - Only required for VNA Home Health Services. Upon Hire Required

Knowledge, Skills, and Abilities:

+ Knowledge of ICD-10-CM, CPT-4, and HCPCS coding.

+ Basic computer skills.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.