Certified Medical Coder
The Coder is responsible for performing various duties to accurately interpret and bill physician charges for physician services in a hospital and a multi-physician practice setting. Performs research and compliance with regulatory coding requirements. Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors. Good working knowledge of medical terminology and anatomy required. This position will provide high quality E/M, procedure and surgery coding across practice specific specialties.
This position is an in office position on a full-time basis.
Qualified candidate must have the following:
Ø At least two years of active surgery coding experience
Ø Be able to maintain a 95% accuracy rate
Ø Perform initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third-party payers.
Ø Interpret progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.
Ø Identify all billable procedures and services; ensuring all appropriate ICD, CPT, HCPCS code(s), and quantities are captured.
Ø Responsible for reviewing patient logs, in office and hospital, and other reports of clinical activity to ensure billing is captured for all patients.
Ø Review and resolve coding edits related to procedures and services charged.
Ø Perform weekly/monthly audits to ensure all services that can be billed are captured and coded for billing.
Ø Review all physician documentation to ensure compliance with third-party and regulatory guidelines.
Ø Maintain a reasonable coding turnaround times for procedure accounts based on date of service.
Ø Responsible for ensuring the batch processes for all coded charges.
Ø Identifies and escalates leadership impacts to timely coding, charge capture, and avoidable delays for billing/reimbursement.
Ø Evaluate medical records to identify documentation deficiencies and provides feedback to the immediate supervisor.
Ø Queries immediate supervisor and or physicians as directed by supervisor/manager, per established policy and procedure when documentation is not clear or conflicting.
Ø Provide immediate supervisor with updates to inform clinicians.
Ø Keep abreast of coding guidelines by self-study, assigned education, coding meeting attendance, or related in-services. Participates in internal and external quality review meetings and audits.
Ø Meet and/or exceeds the established quality standard of 95% accuracy rate or better while meeting and/or exceeding established production standards.
Ø Work closely with Accounts Receivables and Surgery Pre-cert/authorization team members to answer all inquiries regarding coding and billing for physicians’ services.
Ø Report to work, meetings, and professional obligations on time.
Ø Participate in administrative staff meetings and attend other meetings and seminars as needed for the current role.
Ø Maintain confidentiality.
Ø Gather and interpret clinical data.
Ø Abide by the Standards of Ethical Coding set forth by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) and adhere to all official coding guidelines.
Ø Attention to detail is crucial to this position.
Ø Manage time effectively and work in a high volume, high accuracy work environment with deadlines.