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.

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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 incentiv e bon us 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 Agencies

Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

Solicitation of Payment

Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention Candidates

Please 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 [HIDDEN TEXT] 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 Accessibility

Ventra 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/.

Emergency Medicine Coding Specialist