• Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Job Summary

• The Coding Specialist is responsible for reviewing documents pertaining to anesthesia encounters to identify all procedures and diagnosis. The Coding Specialist must ensure the encounters have been coded correctly based on documents received. The Coding Specialist must ensure encounters are coded using the most current coding guidelines. The coding auditor should be able to communicate and recognize inadequate or incorrect documentation so that all coding is completed compliantly.

Essential Functions And Tasks

• Performs ongoing analysis of medical record documentation and codes assigned per CMS, CPT, and Ventra Health documentation guidelines
• Assign appropriate ICD-10-CM and CPT codes and modifiers according to documentation
• Perform MIPS review as needed
• Perform Provider QA as needed
• Document coding errors
• Perform audits at an average of 10-15 charts per hour
• Assist coding management
• Assist with client/provider audits as needed
• Assist with reviewing work product of new coders in training, as needed
• Provides feedback to coders on coding discrepancies/deficiencies, as needed
• Provides feedback to coding manager on documentation deficiencies in a timely manner
• Respond to questions from designated coders
• Maintain confidentiality for all personal, financial, and medical information found in medical records per HIPAA guidelines and Ventra Health policy

Education And Experience Requirements

• High School diploma or equivalent
• RHIT and/or CPC required
• At least one (1) year of medical billing preferred

Knowledge, Skills, And Abilities

• Understand the use and function of modifiers in CPT
• In-depth knowledge of CPT/ICD-10 coding system
• Ability to read and interpret documentation and assign appropriate codes for diagnosis and procedures
• Ability to read, understand, and apply state/federal laws, regulations, and policies
• Ability to remain flexible and work within collaborative and fast paced environment
• Ability to communicate with diverse personalities in a tactful, mature, and professional manner
• Knowledge of the requirements of medical record documentation
• Knowledge of medical terminology and anatomy
• Strong oral, written, and interpersonal communication skills
• Strong time management and organizational skills
• Basic use of computer, telephone, internet, copier, fax, and scanner
• Basic knowledge of Outlook, Word, and Excel
• Become proficient in the use of billing software within 4 weeks and maintain proficiency
• Understand and comply with company policies and procedures

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