MEDICAL CODING COMPLIANCE SPECIALIST - REMOTE/HYBRID

Cooper University Health Care is an integrated healthcare delivery system serving residents and visitors throughout Cape May County. The system includes Cooper University Hospital Cape Regional, three urgent care facilities; Cape Regional Physicians Associates with primary care and specialty care providers delivering services in multiple locations throughout Cape May County; The Cancer Center at Cooper University Hospital Cape Regional, the Claire C. Brodesser Surgery Center; AMI at Cooper, Miracles Fitness and numerous freestanding outpatient facilities providing wound care, lab, and physical therapy services. We have a commitment to our employees by providing competitive rates and compensation programs.  Cooper offers full and part time employees a comprehensive employee benefits program, including health, dental, vision, life, disability, retirement, on-site Early Education Center (employee discount), attractive working conditions, and the chance to build and explore a career opportunity by offering professional development.

Cooper University Hospital Cape Regional is accredited by and received the Gold Seal of approval from The Joint Commission.

Demonstrate proficiency in working claim edits, denials and rejections to support revenue cycle goals with timely and accurate billing. Collaborate with other departments to alert and resolve coding issues, CDM issues and other compliance issues effecting reimbursement. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Addresses NCCI, OCE, LCD and other coding edits as applicable.

1. Works pre-bill Inpatient and Outpatient accounts that have failed for billing due to NCI edits, Medical Necessity, MUE, demographics, provider information, admission status, discharge disposition, etc.
2. Examines Inpatient and Outpatient post bill rejections and denials, makes corrections to facilitate timely rebilling.
3. Demonstrates the ability to optimize revenue cycle operations by reviewing, analyzing, and correcting coding and billing errors in medical claims to ensure accuracy and compliance with federal, state, and payer-specific regulations.
4. Collaborates with Ancillary Departments to determine reason for billing failures and provides education to mitigate future risk.
5. Ability to apply ICD-10 codes appropriately to outpatient services and procedures not coded by HIM (HB Background, Simple Visit Coding, and other OP Areas).
6. Demonstrates a consistent level of performance; strives to maintain a steady level of productivity.
7. Demonstrates the ability to identify erroneous charges and correct claims for rebilling.
8. Demonstrates the ability to confirm the charges are linked correctly for accounts to leave as clean claims.
9. Works as a team member to meet department goals.
10. Performs all related duties or special projects as assigned/required.

3-5 years of relevant experience required. Knowledge of NCCI, OCE and LCDs mandatory. Must have a minimum of one year’s experience in outpatient coding and/or hospital billing and follow up. Applicant must have demonstrated proficiency in coding multiple outpatient services including, but not limited to: Observation, Multi-specialty Oncology, Same Day Surgery, Endoscopy, Emergency Department, etc.

High School diploma or equivalent required

One or more of the following: RHIA, RHIT, CCS, CIC, COC, CPC, CCA, CCC, CIRCC,

CCVTC and/or any of the Core Credentials or specialty credential of AAPC or

AHIMA.