Certified Coder is a nonexempt position responsible for front office and general coding billing duties. Responsible for Coding Audits, Claim, Billing review and compliance.
- Knowledge of billing practices and clinic policies and procedures.
- Knowledge of coding and clinic operating policies.
- Knowledge of medical terminology
- Knowledge of health care insurance claim practices and compliance.
- Knowledge of computer systems, programs, and applications.
- Proficient skills in computer programs.
- Skill in using a calculator.
- Ability to understand and interpret policies and regulations.
- Ability to read and interpret medical charts.
- Ability to examine documents for accuracy and completeness.
- Ability to communicate effectively and work with others.
Major Duties and Accountabilities
- Coordinates with clinical staff to verify charge and/or documentation information as needed
- Audits information about procedures performed and diagnosis on charge.
- Audits 100% of new provider claims
- Audits providers quarterly for correct coding and optimal reimbursement
- Provides education to clinical staff as necessary with coding/documentation
- Reports quarterly on Bell Curves
- Responsible for Athena Work Lists as apply to med necessity and/or coding denials
- All other duties as assigned by the Business Office Manager
- Role model for organization’s core values
- Customer Service: Demonstrates the highest standards for friendly, courteous and caring interaction with patients, physicians, customers, and fellow employees.
- Professional presence
- Communication Demonstrates ability to accept and understand instructions, expresses self clearly and concisely.
- Adaptability/Flexibility Demonstrates the ability to cope with pressure, grasp new ideas and methods, and adjust responses to meet the changing work environment.
- Independence/initiative Demonstrates reliability, follow‑through, ability to work with minimum supervision, and desire and ability to accept additional responsibility.
- Emotional Intelligence Maintain basic emotional and social competencies to include self-awareness, self-regulation, motivation, empathy, and social skills.
- Equipment operated; Standard office equipment including computers, fax machines, copiers, printers, telephones, calculators, etc.
- Education/Experience: Must have a high school diploma & AAPC or AHIMA Certification. Prefer minimum of one year coding experience in a health care organization.
- Physical: Position is in a well-lighted office environment and sitting and standing associated with a normal office environment.