Kettering Health
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
Kettering Health, Miamisburg, Ohio, us, 45343
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
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Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
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Kettering Health Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
2 months ago Be among the first 25 applicants Join to apply for the
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
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Kettering Health Get AI-powered advice on this job and more exclusive features. Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether its by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach. Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether its by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
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 specialty certification
Prior experience in professional fee coding/billing
Knowledge And Skill
CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits
Medical Terminology and Anatomy & Physiology
Computer and EPIC Applications
Excellent verbal and written communication skills
Abilities
Charge Review WQ [Edits] Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Claim Edit WQ [Edits] Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Follow Up WQ [Denials] Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Departmental Responsibilities Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits Follow procedures pertaining to position Researches and resolves concerns timely Seniority level
Seniority level
Entry level Employment type
Employment type
Full-time Job function
Job function
Other Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Kettering Health by 2x Sign in to set job alerts for Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days roles.
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Join to apply for the
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
role at
Kettering Health Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
2 months ago Be among the first 25 applicants Join to apply for the
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
role at
Kettering Health Get AI-powered advice on this job and more exclusive features. Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether its by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach. Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether its by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
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 specialty certification
Prior experience in professional fee coding/billing
Knowledge And Skill
CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits
Medical Terminology and Anatomy & Physiology
Computer and EPIC Applications
Excellent verbal and written communication skills
Abilities
Charge Review WQ [Edits] Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Claim Edit WQ [Edits] Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Follow Up WQ [Denials] Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Departmental Responsibilities Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits Follow procedures pertaining to position Researches and resolves concerns timely Seniority level
Seniority level
Entry level Employment type
Employment type
Full-time Job function
Job function
Other Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Kettering Health by 2x Sign in to set job alerts for Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days roles.
Dayton, OH $97,300.00-$125,544.00 2 weeks ago Development Coordinator(City Manager's Office)
Engineer-In-Training(Department of Public Works and Department of Water)
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Dayton, OH $12,700.00-$25,000.00 5 months ago Dayton, OH $12,700.00-$25,000.00 5 months ago Middletown, OH $126,169.68-$182,056.16 4 days ago Adjunct - Mathematics (On-Campus / In-Person Teaching) Middletown Campus
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Wright-Patterson Air Force Base, OH 1 day ago Director of Housing Assignments and Operations
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Wright-Patterson Air Force Base, OH $109,308.00-$142,103.00 1 day ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr