Ophthalmic Coding Specialist

Our take on this role

About this role

Review medical records and assign diagnosis and procedure codes for a retina ophthalmology practice. The role reports to the Spurs Lane office in San Antonio.

What could you bring from clinical work?

• Nurses: Your experience documenting patient diagnoses and procedures could help when reviewing records and assigning diagnosis and procedure codes.
• PTs: Documenting conditions and procedures according to clinical protocols may help you check code accuracy and sequencing against government and insurance requirements.
• OTs: If you've identified inconsistencies in clinical records, that experience could help with chart audits and documenting errors according to practice protocols.

Full job description from Retina Consultants of Texas

Overview
Retina Consultants of Texas (RCTX) is seeking an Ophthalmic Coding Specialist to join our innovative team with the mission of Fighting Blindness For The World To See. This position will review medical records and assign accurate diagnosis and procedure codes to the patient's health information record. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions, and procedures utilizing various coding classification schemes, including ICD-10-CM (may include PCS), and HCPCS/CPT. This role will report to our Spurs Lane office in San Antonio.

Retina Consultants of Texas is the largest and most respected retina-only ophthalmology practice in the United States. Our group consists of 26 world-renowned physicians leading the world in retinal care. While serving two major metropolitan markets (and their extensions), our combined culture allows us to best serve our patients, referral sources, and our own team of physicians. RCTX also invests heavily in diagnostic equipment, providing state-of-the-art retina imaging, laser, and diagnostic capabilities to each patient. This, combined with the clinical expertise of our physicians, an outstanding and devoted staff, and 25 convenient locations to serve our patients.

We worked hard to create our culture as Retina Warriors. We strongly emphasize our core values of Hard Work, Authentic Care and Innovation in everything we do. It is our belief that by investing in our people, our people will be empowered of their own accord to provide the highest quality patient experience.

In addition to being highly challenged professionally, upon joining our practice, the following competitive benefits for full-time eligible employees after a 60-day introductory period:

Employee Paid Benefits such as Medical, Dental, and Vision, short-term disability, voluntary life insurance, accident, critical illness, hospital indemnity, pet insurance, HSA pre-taxed contributions, 401 (k) retirement savings contributions both Roth and Traditional options starting date of hire.

Employer Paid Benefits such as long-term disability, $25,000 basic life insurance policy, 3% 401(k) safe harbor contribution, HSA employer contributions, annual performance merit increases, certification opportunities, rewards & recognition platform, WellHub Starter Plan Gym Membership, paid time off, and (8) paid holidays + (1) floating holiday annually.

Pay Rate is $22.00+ per hour and is eligible for overtime.

RCTX is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, age, national origin, disability, military service, veteran status, genetic information, or any other protected class under applicable law.

Responsibilities
Duties and Responsibilities:

Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes.

Ensure codes are accurate and sequenced correctly in accordance with government and insurance requirements.

Accurately documents chart errors according to practice protocols.

Code minor and major surgical procedures (intravitreal injections/retina surgeries)

Assists with initiating billing and re-billing for various procedures using appropriate CPT/ ICD coding.

Conduct internal chart audits

Partner with cross-functional teams to resolve patient billing questions and inquiries

Respond timely to insurance company inquiries in company systems

Monitor aging accounts report to identify accounts with delinquent items to action

Handle business office phone calls as needed

Represent the practice in a professional manner and treat all patients, both internal and external, in a courteous manner

Performs other tasks as required.

Skills/Competencies:

Basic understanding of algebraic principles.

Knowledge of minor and major surgical procedures (intravitreal injections/retina surgeries)

Understands Medicare and other common insurance requirements for quality reporting in order to help practice comply with payer requirements.

Knows required components of examination for appropriate coding (ICD-10 selection/CPT coding) to ensure all elements are accurately completed.

Training and understanding of HIPAA requirements and the importance of maintaining patient confidentiality.

Ability to learn Nextgen/Nextech quickly and efficiently

Strong, professional interpersonal skills.

Understanding of medical terminology and/or ophthalmic terminology

Maintain calm and positive attitude and maintain a professional demeanor in stressful situations. Have the ability to respond to changing workload and work environment.

Excellent verbal and written communication.

Management of multiple projects simultaneously.

Strong computer skills with a high degree of accuracy on data entry and attention to detail

Must maintain patient confidentiality in accordance with clinic policy and HIPPA guidelines.

Qualifications
Education Requirements

High school diploma or GED equivalent

College degree preferred

Experience Requirements:

Minimum of two years’ experience in a medical office, preferably an ophthalmology office.

Experience in medical billing and knowledge of CPT/ICD-10 coding required

Scribe certification preferred

Ophthalmic coding preferred

Physical Abilities:

Must be able to multi-task and work in a fast-paced environment.

Work may require sitting for long periods of time

Requires manual dexterity sufficient to operate a keyboard, calculator, telephone, and other office equipment.

Note:

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.