Overview About Our Company We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians. When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.
Position Summary High level understanding and ability to review/abstract appropriate CPT-4, ICD-10-CM, HCPCS and modifiers for patient encounters and procedures. Must also exhibit an of understanding of AMA, specialty specific coding/billing/auditing concepts & compliance guidelines (CMS/OIG/Federal/State regulations) to perform daily functions. Daily use of various EMRs and other clinical, coding applications, along with Microsoft application (word, excel, outlook, etc.) is required. The Coding Specialist is expected to apply knowledge of anatomy and function as well as disease processes to CPT coding and ICD10CM coding.
Essential Job Functions Monitoring and working work queues/dashboard for assigned providers and specialties, to include coding, researching, and trending of coding/billing behaviors.
Code all documented professional services provided in both clinic and other facilities
Applies CPT-4, ICD-10-CM, HCPCS and modifiers following coding guidelines
Adheres to official coding guidelines, AMA and CMS
Expert in reviewing assigned providers/specialty areas
Ensures coded services, provider charges and medical record documentation meet appropriate guidelines and standards
Keeps abreast of coding guidelines and reimbursement reporting requirements
Illustrate knowledge of healthcare industry in areas of coding, revenue cycle, claims and state specific insurance/laws
Ensure timely charge review/processing of daily submissions
Monthly review of reports to identify and abstract any missed charges in assigned specialties
Works collaboratively with Team to ensure monthly goals are met
Responsible for creating/updating reference tools for assigned specialties as needed (tip sheets/coding guidelines, etc.)
Utilize appropriate application/methods to ensure all documented professional services are submitted timely
Ability to identify/trend/summarize potential compliance, coding, billing concerns and bring forth a potential resolution
Other duties as assigned
Education, Certification, Computer and Training Requirements High School Graduate/GED required. Associate’s or Bachelor’s degree preferred.
Coding Certification(s): CPC, CCS-P, CCA, CCS or RHIT, RHIA- Required.
5+ years’ experience preferred / 2 years minimum required.
Multispecialty coding exposure/experience preferred
EMR experience required / exposure to various EMRs preferred
Proficient use of Microsoft Office Applications (Excel, Word, Outlook, Teams)
Physical Job Requirements Sitting long lengths of time
Extensive use of computer / other applications
Ability to multi-task, organize & prioritize work
Ability to work with diverse personalities
Ability to work remotely
Total Rewards and Equal Opportunity This is a non exempt position with hourly rate of $22.00-$25.00/hr based on experience. Total Rewards at VillageMD Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan. Equal Opportunity Employer Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
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