Northern Light Medical Transport and Emergency Care Department: Patient Financial Services Position is located: Cianchette Professional Blding Work Type: PRN Hours Per Week: 10.00 Work Schedule:No Hours Assigned *Temporary Position* Summary: The Coding Specialist is responsible for coordination of and participation in the coding and billing process of the organization. Responsibilities include analyzing the EHR and applying accurate coding and charges for submission to all payers. The incumbent is responsible for understanding the billing claim cycle including prior authorizations requirements, patient eligibility, and coding denial resolutions. The Coding Specialist is responsible for continuing education requirements of the NAAC to maintain and active CAC certification. This position is held accountable to adhere to the policies, procedures, and applicable laws; including metrics related to productivity and quality. Performance reflects the mission and values of the organization. Responsibilities: + Assign ICD-10-CM/PCS, CPT codes adhering to Official Coding Guidelines, CMS, and payer specific guidance. + Analyzes claim documentation for medical necessity, signatures, and other payer requirements. + Reviews and applies claim charges as applicable. + Query providers and crew when documentation needs clarification through email or MEFIRs. + Follow prior authorization processes. + Maintains and exhibits a current knowledge of profession and completes required continuing education. + Attends and participates in the weekly coding review meetings and weekly 1:1 with supervisor. + Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and/or protocol when involved or observed. + May perform other duties upon request. Other Information: + Two years of related experience, one of which is in customer accounts and billing. + Knowledge of requirements of the Centers for Medicare & Medicaid Services (CMS) claims forms; CMS-1500 and CMS-1450 (UB04). + Knowledge of requirements of the Government and Non- Government payment policies & payer contracts. Competencies and Skills + 2+ years of relative work experience required. + Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed. + Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively. + Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit. + Develops Self and Others:Takes responsibility for engaging in professional self-development activities and programs. Strives to gain insight into their own values, strengths and weaknesses, interests and ambitions and takes action in order to enhance competencies and skills when possible. As a leader, encourages and guides employees towards growth opportunities to enhance performance and help them reach goals. Reviews and analyzes employees' strengths and weaknesses to distinguish their talents and development needs, and to ensure they are enhanced appropriately. + Exercises Sound Judgment & Decision Making: Understands and processes complex information, which allows for appropriate and accountable conclusions. Does not react too quickly or slowly. Balances facts, goals, and potential approaches taking the appropriate criteria into account. Makes active decisions and commits oneself by communicating confidently and respectfully. + Fosters Innovation: Employs and encourages the use of meaningful creativity in solving challenges. Proactively identifies opportunities and uses new approaches to enhance processes, systems and services. When appropriate, suggests or initiates new strategies, products, services, and markets. + Promotes Health and Safety: Promotes a healthy and safe environment for patients, employees and visitors. Advocates and models healthy physical and mental health behaviors even in challenging circumstances. Sets high quality standards and strives for continuous improvement and quality assurance by reporting and encouraging others to report near misses and safety issues. + Utilizes Resources Effectively: Understands how to get the most out of available resources and uses cost-benefit thinking in decision-making and in setting priorities. Monitors and analyzes resource usage to identify and eliminate areas of waste and maximize resources. As a leader, defines targets and provides appropriate means; oversees progress and makes adjustments when necessary. Appropriately delegates work, sets clear direction and manages workflow and time. + Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan. + Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of belonging, empowerment, and cooperation. + Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved. + Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others. Working Conditions + Prolonged periods of sitting. + Lifting, moving and loading less than 20 pounds. Position CoderLocation Req ID 81875