A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements.
Responsibilities
Translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS).
Analyze patient records for completeness, accuracy, and compliance with coding guidelines.
Research and analyze data needs for accurate and timely reimbursement.
Conduct chart audits, identify coding discrepancies, and implement corrective actions.
Communicate effectively with healthcare providers to clarify coding issues and ensure accurate documentation.
Stay abreast of changes in coding guidelines, regulations, and technology.
Qualifications
Education
Certified Professional Coder (CPC) or Certified Coding Specialist Physician Based (CCS-P) or Certified Radiology Coder (RCC) is required.
Experience
Prior experience doing physician/provider professional fee billing is preferred.
Skills and Abilities
Strong understanding of coding systems (ICD-10, CPT, HCPCS) and coding guidelines.
Attention to detail and ability to meticulously review documentation.
Effective communication with healthcare providers, billing staff, and stakeholders.
Problem solving ability to identify and resolve coding discrepancies and errors.
Organizational skills: maintain accurate records, manage workload, and prioritize tasks.
Computer skills: proficiency in coding software and electronic health records (EHR).
Must be able to use personal transportation for courier duties.
DCH Standards
Maintain performance, patient and employee satisfaction, and financial standards as outlined in the performance evaluation.
Perform compliance requirements as outlined in the Employee Handbook.
Adhere to DCH Behavioral Standards, including creating positive relationships with patients/families, coworkers, and with oneself.
Perform essential job functions ensuring safety of patients, visitors, and employees.
Identify and reduce unsafe practices that may result in harm to patients, visitors, and employees.
Take appropriate action to reduce risks and hazards, promoting safety for patients, visitors, and employees.
Use electronic mail, time and attendance software, learning management software, and intranet.
Adhere to all DCH Health System policies and procedures.
All other duties as assigned.
WORKING CONDITIONS
Physical presence onsite is essential with a possibility of a hybrid work schedule. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation. Valid driver’s license and automobile liability insurance. Very good interpersonal communication and customer service skills required.
Physical
Medium work – Exerting 20–50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly on various objects. Physical demand requirements exceed those for Light Work.
Good manual and finger dexterity.
Ability to tolerate prolonged periods of sitting.
Some light driving required.
Psychological
Contact with others, dealing with external customers/clients, sometimes dealing with unpleasant people.
Occasionally coordinate letters/memos, and work with work groups or as a team constantly/consistently.
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