Certified Coder- Physician Billing
- Murray Calloway County Hospital
- Hybrid
Job Description
The incumbent performs highly technical and specialized functions. The employee reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. The primary function of this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
Completion of high school, or equivalent.
Completion of high school, or equivalent. Two years of coding experience using ICD-10-CM, CPT and HCPCS. CCS, CCS-P or CPC certification required.
Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.
Maintains hospital standards for a clean and quiet patient environment to maintain a positive patient care experience.
Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.
Adheres to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.
Participates in ongoing quality improvement activities.
Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
Complies with organizational and regulatory policies for handling confidential patient information.
Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.
Abstracts all necessary information and assigns codes (ICD-10-CM, CPT & HCPCS), which most accurately describe each documented diagnosis, surgical procedure and special therapy or procedure according to established guidelines.
Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.
Quantitative analysis – Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Qualitative analysis – Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third party reimbursement agencies and special screening criteria.
Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code.
Operates RPMS peripheral equipment (CRT and printer) for the purpose of key-entering data for the process of updating or changing health summaries for patient information files. Experience with Oracle Cerner preferred.
Performs all duties according to established safety procedures and tribal policy.
Performs other duties assigned by the supervisor and/or director.
Required Experience Level
Minimum Education
Murray-Calloway County Hospital (MCCH) is an independent, not-for-profit community hospital located in Murray, Kentucky, serving Western Kentucky and the surrounding region. With a history of caring for families since 1910, MCCH provides comprehensive inpatient and outpatient services, supported by a multispecialty provider network, modern facilities, and advanced technology, including robotic-assisted surgery, precision radiation oncology, and diagnostic imaging. Guided by our mission to provide the care we would expect for our own family, MCCH combines compassionate, personalized care with a collaborative environment that values clinical excellence, professional growth, and local decision-making.