Pro Fee Coding Specialist - Pro Services Coding

Job description

Responsibilities & Requirements This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist: Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. - Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits - Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 - Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy] - Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits - Corresponds with providers on pending claims to facilitate resolution - Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies - Communicate appropriately with providers, leaders, and staff - Researches and resolves concerns timely Educational Requirements: High School Diploma or equivalent RHIT, RHIA, CCS, CCS-P, CPC or eligible s...