The PNS Coding Specialist II (CS II), will be responsible for accurately abstracting and assigning valid ICD, CM, CPT codes to ensure appropriate reimbursement in accordance with federal and state regulatory guidance, for Provider Network Services. The CS II will determine the most appropriate diagnosis after a thorough review of the medical records and works closely with practice staff with regards to coding and assignment. The CS II will also review accounts to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission of billing for payment. The CS II will compare charges on accounts with the procedures coded and identifies and notifies Director any discrepancies. If an account is denied due to incorrect coding, the CS II will conduct medical records research and report finding to the Director of PNS Revenue Cycle.

Qualifications:

Education:

• High school diploma required.

Experience:

• A minimum of 6 months previous experience using ICD, CM, CPT programs in an out-patient or physician office setting required.
• A minimum 1 year previous experience in physician reimbursement required.
• Previous experience using an electronic health record preferred.

Licensure/Certification/Registration:

• Certified Professional Coder (CPC) by an accredited certifying agency required. (preferably AAPC)

Special Skills:

• Ability to work effectively and collaboratively with physicians, clinical and office staff personnel and ancillary hospital departments required.
• Exemplary core customer service skills strongly required.
• Strong organizational skills required.
• Strong PC skills required.
• Strong verbal and written communication skills required.
• Exposure to or knowledge of encoding software and impact of coding and reimbursement assignments required.

Working Conditions:

• Stress level high due to multiple demands frequently occurring simultaneously.
• Physical surroundings pleasant and comfortable
• Generally contained office type environment
• Most work performed while sitting, however, a moderate amount of walking and moving around within a confined area occurs