Physician Coder (FT)

Description

JOB SUMMARY

The Physician Coder I performs evaluation/management coding for clinic, inpatient, and outpatient encounters as well as coding for in-office ancillary services and minor procedures. Assigns and sequences all codes for services rendered. Collaborates with coders, billers, clinical staff, managers, and healthcare professionals to ensure accurate coding assignment and to resolve any coding-related claim denials.

JOB DUTIES AND RESPONSIBILITIES:

Job Specific:

Physician Coder I Duties:

1. Assigns codes to diagnoses, hospital visits, office visits, and in-office ancillary services and minor procedures using correct CPT®, HCPCS Level II, and ICD-10-CM codes. (EF)
2. Ensures that assigned codes are accurate and sequenced correctly in accordance with coding guidelines, as well as insurance and government regulations. (EF)
3. Examines patient medical record to ensure coding accurately reflects the documented medical care provided. (EF)
4. Demonstrates continued improvement on coding reviews and audits, until 90% accuracy is met and maintained. (EF)
5. Submits and documents provider queries in a compliant and timely manner. (EF)
6. Posts coded records to the practice management system in accordance with insurance payer requirements and policies. (EF)
7. Reviews all coded and posted invoices daily, weekly, and/or monthly to identify and correct any pre-billing errors.
8. Reviews and corrects coding rejections and denials that do not require appeal.
9. Reviews and works assigned work queues in a timely manner to meet insurance payor timely filing and appeal deadlines.
10. Consults team members, supervisor, director, and other appropriate resources to resolve coding and documentation questions and issues. (EF)
11. Communicates timely and professionally with outside providers or hospital affiliations to obtain information needed to code services per coding and carrier guidelines. (EF)
12. Communicates timely and professionally with physicians and managers of any problems arising from incorrect, incomplete coding or documentation. (EF)
13. Maintains a collaborative relationship with clinic staff, managers, physicians, advanced practice providers, and the billing department.
14. Plans and participates in departmental meetings with clinic staff, managers, administrators, advanced practices providers, and physicians. (EF)

Hospital:

1. Adheres to organization-wide and other applicable policies and procedures.
2. Day-to-day performance complies with the hospital's Service Excellence Behavioral Expectations.
3. Performs within the prescribed limits of the hospital's Ethics, Compliance and Confidentiality Program guidelines.
4. Performs within professional Scope of Practice at all times.

Other Duties As Assigned:

• Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time

Minimum Requirements

EDUCATIONAL REQUIREMENTS

Required: Physician Coder I: High School diploma or equivalent; Completion of an approved medical coding program; entry level knowledge of medical coding.

Preferred: Associates degree in a healthcare related field; Knowledge of pathophysiology and basic pharmacology; Entry level knowledge of health insurance (HMO, PPO, Medicare, Medicaid, etc.)

EXPERIENCE

Preferred: One year of medical coding or billing experience in a physician office/practice setting.

SPECIAL SKILLS AND ABILITIES

Required: Able to work in a collaborative, team environment; able to organize and complete work in a timely manner; good mathematical, typing and 10-key speed and accuracy skills; good verbal and written communication skills; proficiency in Microsoft Office365 apps; proficiency using telephone, fax, and email; able to effectively utilize an online coder.

Preferred: Able to abstract the medical record for correct CPT®, HCPCS Level II, and ICD-10-CM code assignment; intermediate proficiency in Microsoft Office365 apps.

LICENSURE / CERTIFICATION REQUIREMENTS

Required: Physician Coder I: Successful completion of an approved medical coding program and obtain an approved coding credential (CPC-A, CCA), or equivalent certification within one year of hire. The manager reserves the right to extend this time frame up to 2 additional years

Preferred: Physician Coder I: Certified Professional Coder (CPC-A or CCA), or equivalent certification

COMPANY PROFILE

Citizens Medical Center is a not-for-profit, community hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 317-bed acute care hospital with over 1,200 employees. Voted "Best of the Best" hospital in Victoria for 14 consecutive years, Citizens Medical Center is a level III Trauma Center, currently renovating its 24/7 Emergency Department that includes an onsite medical helicopter. Citizens has a comprehensive Community Cancer Program that includes two linear accelerators and HDR brachytherapy. Citizens is recognized for its outstanding cardiology program which includes a nationally accredited Chest Pain Center and is a Primary Stroke Center. Citizens also includes a comprehensive, accredited Bariatric Surgery program, Birth Center with labor and delivery, an imaging and surgery center, sleep study center, state-of-the-art rehabilitation and fitness center, urology center and daVinci robotics minimally invasive surgery options, a home health agency, and has a long history of providing continuing education for healthcare providers and the community.

Citizens Medical Center is looking for employees who display respect and enthusiasm for patients, visitors, and coworkers, and who consistently uphold the organization's commitment to providing outstanding outcomes and an excellent experience.

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

BENEFIT OFFERINGS

Health

• Medical, Dental, Vision
• STD, LTD Disability
• Supplemental Life, AD&D
• Flexible Spending (FSA)
• Employer paid life insurance and short term disability

Retirement/Investment

• Defined Benefit Pension Plan
• 457(b) Deferred Compensation

Well-Being Benefits

• Paid Time Off
• Sick leave, Bereavement leave, Jury Duty/Witness Service
• Tuition Reimbursement
• Hospital-paid & administered annual immunizations
• HealthPlex (gym) membership discount
• YMCA partnership discount for childcare
• Employee Assistance Programs

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