Coding Specialist

Job Overview:
The Home Health and Hospice Coder is responsible for accurately coding patient medical records and claims for home health and hospice services. This role ensures compliance with coding guidelines, assists in proper billing, and contributes to the efficiency of the healthcare facility’s financial operations.

Key Responsibilities:

• Code Medical Records: Review clinical documentation from home health and hospice providers to accurately assign appropriate ICD-10, CPT, and HCPCS codes for diagnoses, treatments, and procedures.
• Ensure Compliance: Maintain knowledge of coding regulations and guidelines (such as ICD-10, HCPCS Level II, and CMS rules), ensuring all codes are compliant with local, state, and federal policies, including Medicare and Medicaid requirements.
• Medical Record Review: Perform chart reviews to verify that all services, diagnoses, and treatments are properly documented and coded, ensuring that all necessary information is included for accurate billing.
• Billing and Reimbursement: Collaborate with billing teams to ensure timely and accurate billing. Work to resolve any coding discrepancies or claim rejections.
• Documentation and Reporting: Provide regular feedback to clinical staff to ensure documentation is accurate and complete. Generate coding reports and track coding metrics.
• Training and Education: Stay up-to-date with coding updates, rules, and procedures. Educate staff and provide guidance to ensure proper documentation practices are followed.
• Quality Assurance: Perform audits to identify and resolve any discrepancies in coding, improving accuracy and minimizing claim denials.

Qualifications

Qualifications:

• Education: High school diploma or equivalent required. Certification required.
• Certifications: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or CHHCS/HCS-D (Certified Home Health Coding Specialist) preferred.
• Experience: Previous coding experience in home health or hospice settings preferred.
• Skills:
  • Proficient knowledge of ICD-10, CPT, and HCPCS coding.
  • Familiarity with home health and hospice regulations, including Medicare and Medicaid billing procedures.
  • Strong attention to detail, organizational skills, and the ability to maintain confidentiality.
  • Excellent communication skills to collaborate with clinical and billing teams.