Position Overview:

Our team is growing! This is a remote role - prefer that candidate hired resides in one of our current markets (Minnesota, Wisconsin, Florida). 

In this multifaceted role, the Medical Coding Specialist is responsible for performing clinical documentation & coding reviews using established standards and codes to optimize reimbursement and ensure compliance for services provided, and analyzing claims for proper documentation and coding, in compliance with state and federal guidelines.

Responsibilities:

• Analyze supporting medical record documentation for professional services to ensure that appropriate ICD-10-CM, CPT, HCPCs codes are assigned according to established correct coding guidelines and standards of ethical coding. 
• Consult with clinical providers for coding and documentation clarification when necessary.
• Conduct prospective and retrospective clinical documentation and coding reviews.
• Provide individual and group feedback and education to clinical providers, medical staff and other staff as a result of the coding reviews and identified coding trends, in accordance with the established compliance plan.
• When provider documentation issues are identified, work with clinical operations and compliance staff to implement corrective action plans.
• Create and revise education and training materials related to documentation & coding
• Answer coding questions from providers and other staff as needed.
• Maintain plan for monitoring and tracking of coding and coding compliance activities.
• Work in conjunction with clinical operations team to evaluate any special requests for review of appropriate coding due to patient complaints, denials, rejections, incorrect coding, etc., and provide feedback to the inquiring source.
• Ongoing review and tracking of insurance rejections/denials with coding discrepancies, contacting insurance companies when necessary.

Qualifications:

Education/Certification/Experience

• Current Medical Coding Certification required
• Hierarchical Condition Category (HCC) experience preferred
• Medical billing experience preferred

Knowledge/Skills/Abilities

• Knowledge of medical terminology and understanding of patient care notes
• Knowledge of ICD-10, CPT, HCPCS codes and claim regulatory guidelines
• Computer proficiency including ability to navigate electronic medical records system, and Google Business Suite
• Excellent organizational skills with the ability to prioritize and work in a fast-paced environment
• Strong attention to detail, follow-through, and commitment to quality
• Work independently and proactively with minimal direction/supervision
• Excellent interpersonal and customer service skills
• Strong written and verbal communication skills
• Skilled in identifying and resolving problems
• Ability to deal with change and ambiguity
• Demonstrated compatibility with Bluestone’s mission and operating philosophies
• Demonstrated ability to read, write, speak, and understand the English language
• Must have received or be willing to receive Covid 19 vaccine by date of hire. Accommodations for disability- and religious-based reasons will be considered

Bluestone Benefits:

• Health Insurance
• Dental Insurance
• Vision Materials Insurance
• Company paid Life Insurance
• Company paid Short and Long-term Disability
• Health Savings Account (HSA)
• Flexible Spending Account (FSA) 
• Retirement plan with 4% matching contributions
• Nine paid (non-working) holidays
• Three weeks (15 Days) Paid Time Off (PTO)
• Mileage reimbursement program for field employees 
• Company sponsored laptop
• Regular business hours