Medical Billing Specialist/Coder, Business Office, Downtown Nashville

SUMMARY: The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice. ESSENTIAL DUTIES AND RESPONSIBILITIES: Reviews daily charges from the electronic health record to ensure coding and billing guidelines are followed Utilizes CPT, ICD-10CM, and HCPCS coding and modifier usage during daily reviews Utilizes various coding and billing references to resolve complex billing scenarios Ensures progress notes are coded accurately and to the highest level of specificity Maintains strong knowledge of payer billing guidelines and policies Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies Timely alert any identified issues and/or risk that may require further research Fulfill month end requirements ensuring all charges capture Ability to meet deadlines and prioritize responsibilities Secondary Responsibilities: Maintains strong knowledge of both local and national CMS policies, as well as various private-payer coding and billing guidelines. Utilizes the Correct Coding Initiative Edit List (CCI) when billing for multiple services during the same encounter and understands how to correctly apply Modifiers. Informs Patient Accounts Department when additional account balance reviews are needed. Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies. Utilizes various coding and billing references to resolve complex billing scenarios. Consistently follows internal coding and billing protocols and policies. Demonstrates a commitment to expand coding & billing knowledge by participating in various continuing education opportunities each year. Demonstrates a positive willingness to take on additional assignments and responsibilities. Must maintain professional and courteous relationships with all team members at all times. Must have predictable and consistent attendance and follow all attendance policies. Skills/Qualifications: Active Certified Coder License CPD, CCS). Required experience in OB/GYN. Epic experience is desirable. SUPERVISORY RESPONSIBILITIES None