Medical Coding Specialist

Required Qualifications

• Minimum completion of educational curriculum required of medical license or coding certification held with Bachelor’s Degree preferred; or minimum Bachelor’s Degree in healthcare related field and at least 2 years of coding experience.
• Current nursing certification and/or current certified coder (CCS, CCS-P or CPC), Registered Health Information Technician (RHIA/RHIT).
• Minimum 2 years experience in direct patient care, medical procedure billing, medical insurance auditing, line item review, audits, coding, and/or reimbursement.
• Knowledge of inpatient/outpatient hospital billing requirements including UB-04s, revenue codes, CPT, HCPCS, ICD-9/10, DRG, APCs, and familiarity with international equivalents (e.g., KSA, ICD-10-AM, ACHI, CCI).
• Knowledge of professional claim billing requirements including HCFA-1500s, CPT codes and ICD-9/ICD-10 diagnoses codes, as well as international claim forms.
• Knowledge of payer reimbursement policies, state and federal regulations, international healthcare systems, and global medical necessity criteria.
• Familiarity with international medical data resources and coding tools.
• Auditing and health information management experience in a healthcare setting preferred.
• Excellent communication (verbal and written), teamwork, training, presentation, negotiation and organizational skills, including cross-cultural communication.
• Proficiency in MS Office Suite and database software; experience with international billing platforms is a plus.
• Ability to handle multiple tasks in a fast paced environment.
• Ability to read and abstract medical records.
• Knowledge of medical terminology, anatomy, and physiology.
• Ability to interact and discuss audit results with providers.
• Required licensures, professional certifications, and/or Board certifications as applicable.
• Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone.