[Hiring] Professional Fee Coding Specialist @Kettering Health

Role Description

This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation.

• Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
• Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits.
• Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10.
• Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy].
• Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits.
• Corresponds with providers on pending claims to facilitate resolution.
• Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies.
• Communicate appropriately with providers, leaders, and staff.
• Researches and resolves concerns timely.

Qualifications

• High School Diploma or equivalent.
• RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification.
• Prior experience in professional fee coding/billing.

Requirements

• CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits.
• Medical Terminology and Anatomy & Physiology.
• Computer and EPIC Applications.
• Excellent verbal and written communication skills.

Company Description

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.