Medical Coding Associate

Medical Coding Associate is responsible for effective and efficient operations by enhancing various operational procedure in the areas of information flow and management, business processes, enhanced management reporting and looks for opportunities to expand and improve business outcomes. Should possess multi-specialty coding knowledge and be able to perform root cause analysis.

Essential Functions (Duties and Responsibilities):

60% Perform Medical coding related responsibilities and ensure seamless assignment codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes

• Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations

• Ensure that defined processes where client interaction are monitored and solved for in the areas where documentation is insufficient or unclear

• Search for information in cases where the coding is complex or unusual

• Receive and review patient charts and documents for accuracy

• Ensure that all codes are current and active

• Analyze and resolve root-cause issues by working with vendors, payers and various athena departments that are stakeholders

• Analyze reports at a day to day operations level and provide insights to the management team indicating sharp spikes or dips in volume

• Use baseline research and analysis to advocate for product and process improvement

• Work closely with outside organization to support and solve outstanding process issues

30% Identify and quantify work trends

• Propose solutions to improve internal processes to facilitate a touchless revenue cycle with broader stakeholder groups

• Drive meaningful co-ordination and results with BPO teams and with internal divisions

• Work with internal teams across the company to prioritize and implement process improvements appropriately prioritized based on impact and business need

10% Accept full ownership and responsibility for special projects

• Work with internal stakeholders and client-facing teams to identify and resolve claim issues impacting individual clients and/or discrete lines of business

• Communicate effectively the status and resolution of special projects, adhere to established timelines, and serve as a valued subject matter expert for internal teams.

Education & Experience Required:

• Bachelor's degree or equivalent

• 5-7 years experience in fast paced environment

• Previous experience in healthcare RCM environment, mandatory

Knowledge & Skills:

• CPC or CCS or equivalent

• Preferred Surgery coders

• CIC or in-patient understanding or experience, mandatory

• Healthcare RCM knowledge, mandatory

• Analytical skills and excellent communication skills

• Problem framing and problem-solving skills

• Ability to perform root cause analysis

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