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The Coding Specialist reviews medical documents to assign accurate ICD-10-CM and CPT codes according to current guidelines. They are also responsible for identifying documentation deficiencies and providing feedback to coders and management to ensure compliant billing.
Requirements
Candidates must have a high school diploma and hold RHIT and/or CPC certifications, along with knowledge of 2023 MDM Guidelines. One year of medical billing experience is preferred.
Full job description
About Us
Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.
Come Join Our Team!
As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards
Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus!
Job Summary
The Coding Specialist is responsible for reviewing documents to identify all procedures and diagnosis. The Coding Specialist must ensure the encounters have been coded correctly based on documents received. The Coding Specialist must ensure encounters are coded using the most current coding guidelines. The Coding Specialist should be able to communicate and recognize inadequate or incorrect documentation so that all coding is completed compliantly.
Essential Functions and Tasks
Performs ongoing analysis of medical record documentation and codes assigned per CMS, CPT, and Ventra Health documentation guidelines.
Assign appropriate ICD-10-CM and CPT codes and modifiers according to documentation.
Perform MIPS review as needed.
Perform Provider QA as needed.
Document coding errors.
Assist coding management.
Assist with client/provider audits as needed.
Assist with reviewing work product of new coders in training, as needed.
Provides feedback to coders on coding discrepancies/deficiencies, as needed.
Provides feedback to coding manager on documentation deficiencies in a timely manner.
Respond to questions from designated coders.
Maintain confidentiality for all personal, financial, and medical information found in medical records per HIPAA guidelines and Ventra Health policy.
Education and Experience Requirements
High School diploma or equivalent.
RHIT and/or CPC required.
At least one (1) year of medical billing preferred.
2023 MDM Guidelines required.
Knowledge, Skills, and Abilities
Understand the use and function of modifiers in CPT.
In-depth knowledge of CPT/ICD-10 coding system.
Ability to read and interpret documentation and assign appropriate codes for diagnosis and procedures.
Ability to read, understand, and apply state/federal laws, regulations, and policies.
Ability to remain flexible and work within collaborative and fast paced environment.
Ability to communicate with diverse personalities in a tactful, mature, and professional manner.
Knowledge of the requirements of medical record documentation.
Knowledge of medical terminology and anatomy.
Strong oral, written, and interpersonal communication skills.
Strong time management and organizational skills.
Basic use of computer, telephone, internet, copier, fax, and scanner.
Basic knowledge of Outlook, Word, and Excel.
Become proficient in the use of billing software within 4 weeks and maintain proficiency.
Understand and comply with company policies and procedures.
Compensation
Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.
This position is also eligible for a discretionary incentive bonus in accordance with company policies.
Ventra Health
Equal Employment Opportunity (Applicable only in the US)Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. Recruitment AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes. Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.
Attention CandidatesPlease be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at [email protected] to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.
Statement of AccessibilityVentra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.
Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and radiology.
Offices: 5001 LBJ Freeway, Suite 320, Dallas, TX 75244, US · 2630 Elm Hill Pike, Nashville, Tennessee 37214, US · 4100 International Plaza, Suite 800, Fort Worth, Texas 76109, US · 5295 Westview Drive, Suite 225, Frederick, MO 21703, US · 10619 S Jordan Gateway, Suite 300, South Jordan, Utah 84095, US
Anesthesia Revenue Cycle ManagementEmergency Medicine Revenue Cycle ManagementAdvisory Solutions for Practice ManagementHospital and Health System ConsultingRCM for Hospital-Based Specialtiesand Advisory SolutionsService IndustryHealth CareAdviceBilling