Certified Coder

Description

Are you Compassionate, Collaborative, Respectful and strive for Excellence?

If so, you share our CORE Values and we invite you to join our team as a Business Office Representative.

Certified Coder Job Description

Reports to:

Revenue Cycle Manager

Billing Office Supervisor

Organizational Peers:

Billing Specialist

Direct Reports:

None

Job Details:

Full Time, 40 hours/week, Monday-Friday

Non-Exempt

Pay Range: $25.75-$33.99/hour

Job Summary:

A Certified Coder is a nonexempt position responsible for front office and general coding billing duties. Responsible for Coding Audits, Claim, Billing review and Compliance.

Performance Requirements:

Knowledge:

1. Knowledge of billing practices and clinic policies and procedures.

2. Knowledge of coding and clinic operating policies.

3. Knowledge of medical terminology

4. Knowledge of health care insurance claim practices and compliance.

5. Knowledge of computer systems, programs, and applications.

Skills:

1. Proficient skills in computer programs.

2. Skill in using a calculator.

Abilities:

1. Ability to understand and interpret policies and regulations.

2. Ability to read and interpret medical charts.

3. Ability to examine documents for accuracy and completeness.

4. Ability to communicate effectively and work with others.

Major Duties and Accountabilities:

1. Coordinates with clinical staff to verify charge and/or documentation information as needed

2. Audits information about procedures performed and diagnosis on charge.

3. Audits 100% of new provider claims

4. Audits clinicians quarterly for correct coding and optimal reimbursement

5. Provides education to clinical staff as necessary with coding/documentation

6. Reports quarterly on Bell Curves

7. Responsible for Athena Work Lists as apply to med necessity and/or coding denials

8. Other duties as assigned

Position Competencies:

1. Role Model for Organization's Core Values: Support the Mission, Vision and Values with dedication to providing excellent care and service and providing comprehensive quality healthcare for our community in a compassionate manner.
2. Customer Service: Demonstrates the highest standards for friendly, courteous and caring interaction with patients, clinicians, guests, and fellow employees.
3. Safety/Infection Control: Observes all safety rules and practices and encourages safe practices in dealing with all patients, visitors, and employees. Conforms with current infection control policies. Maintains compliance with Cal OSHA safety guidelines.
4. Communication: Demonstrates ability to accept and understand instructions, expresses self clearly and concisely.
5. Attendance/Punctuality: Is seldom tardy and or absent, Attends mandatory in-service programs and/or committees as assigned.
6. Adaptability/Flexibility: Demonstrates the ability to cope with pressure, grasp new ideas, methods, and adjust responses to meet the changing work environment.
7. Confidentiality: Assures patient and clinic confidentiality. Complies with HIPAA guidelines regarding patient confidentiality and protected health information.
8. Independence/Initiative: Demonstrates reliability, follow-through, ability to work with minimal supervision, desire and ability to accept additional responsibility.

Job Qualifications:

Equipment operated: Standard office equipment including computers, faxes, copiers, printers, telephones, calculators, etc.

Education/Experience: Must have AAPC or AHIMA Certification. Minimum of one year coding experience in a health care organization is preferred.

Physical: Climbing, stooping, kneeling, crouching, reaching, handling, pushing, feeling with both hands, twisting, reaching above, at or below shoulder level, eye/hand/foot coordination. Will stand and walk 20-30% of the time and sit 70-80% of the time. Temperatures of the working areas vary from cold to warm. Exposure to communicable diseases, sharp instruments and bodily fluids.

I am able to perform these tasks without accommodation. _____Yes _____No

If no, list required accommodation(s):

I have read and understand the above job description, and I accept all the responsibilities of the position.

____________________________________ ___________________Employee's Signature Date

Responsibility for Review and Maintenance:

Date Initiated: 2009

Date Revised: 2022, 2025