Convergent, a Healthcare Receivables company located in Boca Raton, Florida is currently looking for a full time Certified Coding Specialist to join its remarkable team. Convergent is a leading provider of Denial Management, Workers’ Compensation and Problem Claims Solutions to hospital systems all over the country.
- The Coding Specialist assists Staff Attorneys and Claims Representatives by reviewing and analyzing medical information from medical records against billed procedures to ensure accurate coding of diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements.
- Performs chart documentation audits, educates staff on current coding practices and performs ad hoc projects as requested by the Director.
- Recommends corrections as needed to ensure accurate billing and reimbursement processing.
- Prepare reports of findings and share with the Managers and assist the Managers in providing feedback to Claims Representatives and Staff Attorneys.
- CCA, CCS, CIC/COC, or CPC-H required.
- 3-5 years of a variety of coding experience, including INPATIENT and OUTPATIENT, at a minimum.
- At least 2-3 years of MS-DRG (Medicare Severity-Diagnosis Related Groups) experience.
- Knowledge of ICD-9, ICD-10 and additional coding categories/types is required.
- Knowledge of Commercial and Government health insurance is a plus.
- Possess medical knowledge, skills and abilities to identify non-compliance in areas of coding practices and medical record documentation, and to recommend billing corrections.
- Able to work independently with a high degree of attention to detail and reliable decision-making abilities.
- Computer skills necessary to provide accurate medical record reviews and any corresponding documentation of results.
- Ability to maintain a standard minimum number of reviews per week.