How You’ll Help Transform Healthcare:

Welcome to a promising future with this unique career opportunituy. At Carilion Clinic, our team provides accurate medical record documentation in a forward-thinking environment.

You will thrive through extensive training, supportive leaders and potential for advancement. Carilion offers comprehensive benefits, paid time off, and tuition options. Join a team where your skills and ideas will make a difference in the health of our patients and the communities we live in.

The Coding Consultant consults with physicians and their practices on Coding protocols and issues to ensure coding reflects all services rendered to ensure maximum reimbursement. Provides Coding education to physicians and staff. Performs audit reviews of practice coding/billing process and/or performs concurrent coding of specific practices. Identifies denial trends and corrects issues to achieve minimal practice denials.

The primary job responsibilities of the coding consultant include, but are not limited to, the following:

• Consults with physicians to identify ICD-10-CM, CPT, HCPCS codes and how and when to use them. Ensures that coding reflects all services rendered for maximum reimbursement. Helps in the process of verifying all ICD-10, CPT, and HCPCS codes to all procedures and sequences codes according to coding guidelines. Establishes guidelines for which codes can be changed by the staff without specific physician approval.
• Periodically assesses coding needs and coding training and information needs. Provides coding information, seminars and/or workshops to educate physicians and staff. Provides information on coding changes and insurance coding updates on a regular basis.
• Keeps up to date with current coding guidelines, changes and billing procedures by reading and attending appropriate seminars. Obtains all documents and other resources needed for coding procedures within the physician practices. Works with management and others to update encounter forms and coding tools utilized in the practices.
• Acts as a Coding information expert and resource to answer questions and advise physicians and others.
• Works with other Coding Consultants and management to establish internal Coding quality control and audit processes. Performs random and regular reviews of different parts of the billing process and specific types of billing, such as pre-bill E/M reviews, concurrent coding of surgical procedures, payor requested audits, RAC audit reviews, and retrieving documentation for 3rd party payors by ROI process with feedback to the physicians and others. Reviews denials for the practices to trend and correct issues. Will be held accountable for the reduction of the practices denials.

Hours are 8am-4:30pm Monday-Friday. OT as needed. Responsible for Provider Education and Audits. Hybrid position- not 100% remote. Must be willing to travel to ambulatory sites or hospitals as needed. CPC Certification required.

What We Require:

Education: High School education required: college degree preferred. Medical Terminology and Physiology Anatomy required.

Experience: The successful internal candidate for Ambulatory Surgery will have a minimum of 1.5 years combined experience in Outpatient and ED Coding, with a consistent accuracy rating of 96% or better. External Candidates must have previous Outpatient, ED experience, with prior Ambulatory Surgery experience referred. Basic computer skills required. Experience in ICD10 and CPT coding

Licensure/Certification: CPC certification required.

About Carilion

This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.