Coding Consultant
The role and Responsibilities/Tasks of Coding Consultant include:
- Codes patient medical records and submits claims to insurance companies
- Provides coding and invoicing services to various businesses in the medical industry
- Ensures and provides reports that coding and documentation meet compliance and quality standards
- Serve as a coding resource to the entire organization staff
- Provides coding education for physicians, operations and staff, along with performing needs assessment
- Researches and also teaches complex coding issues and concepts
- Maintains a knowledge base regarding coding policies and guidelines from CMS and other payers
- Develop and implement coding improvement plans
- Advises and consults providers and business office staff on coding issues
- Coding Consultant’s average earning capacity in 2012 ranges anywhere between approximately $43,000 - $85,000 per annum depending on organization size or type, area, expertise, industry and so on (figures taken from industry sources)
Minimum Qualifications-
- Employment requires a high school diploma
- Recommended coursework include- math, biology and data processing
- Certifications or licensing are not generally needed but may be required by certain employers as additional options
Additional certifications generally include-
- The American Health Information Management Association (AHIMA) certification for Registered Health Information Technicians (RHIT), or a Registered Health Information Administrator (RHIA), which requires to be a graduate of an accredited two-year associate degree and passing a written exam
- The American Academy of Professional Coders (AAPC), the Board of Medical Specialty Coding and Professional Association of Health Care Coding Specialists - different credentialing in coding and specialized coding (RHIA, RHIT, CCS, CCS-P, CPC, CCA, and CPC-H)
- Successful completion of ICD_10 (minimum version 2) Introductory qualification
- Added benefit though not compulsory to complete college coursework- accounting or business
- Advantageous to continue education and get updated with current training and practices in coding and billing software
- Attention to detail is important to be a successful coding consultant
- Research skills are an added benefit to interpret new industry terminology
- Added advantage to be posses problem solving skills and conflict resolution
- Computer and medical coding skills are required as well
- Specialization in clinical classification and health care reimbursement methods
- Knowledge of Health care environment and commitment to accuracy
- Knowledge of Quality Assurance and accreditation principles
- Communication, presentation, interpersonal and customer service skills
- Preferable to posses knowledge of Medicare compliance issues and healthcare billing and reimbursement in a fee-for-service environment
- Advantageous to have an extensive knowledge about both hospital and clinic experience
- Work as independent contractors, rather than as direct employees, and can be hired by a medical facility or an insurance company
- Since they work independently, they could work at the office or hospital holding their contract, at their own office or even from home
- Employers for billing and coding consultants include hospitals, doctors' offices, outpatient care centers, nursing homes, rehabilitation centers, pharmacies and insurance companies
- According to BLS, employment in billing and coding careers is expected to grow along with many other health information management positions, at a rate of 20% from 2008 to 2018
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