Senior Certified Professional Coder (CPC)

CH Revenue Management Solutions (CHRMS)(forthesurgeons.com) is seeking a Senior Certified Professional Coder (CPC) to join its growing company. CHRMS is a single source solution for maximizing out-of-network reimbursement using medical billing and revenue recovery services to providers across the country. Our team is comprised of more than 70 professional medical billers, coders, insurance industry professionals, medical practice managers and ERISA and state regulatory experts. This opportunity is for the right individual looking to be in an entrepreneurial work environment.

The Senior CPC will provide quality review and analysis of a wide range of patient medical records, ensure accuracy of client coding, and submit charges to healthcare payors for reimbursement. This role will include establishing payor coding guidelines across multiple specialties and identifying client coding conflicts. Responsible for also reviewing medical records for quality control and assure proper billing of the medical record, comparison of physician chosen CPT and ICD-10 codes to the physician’s documentation to substantiate the level of coding, and complete review of medical records to accurately optimize all professional services documented for submitting charges. This is an in-office position.

Plastic Surgical Coding, A PLUS

Key Responsibilities:

• Establishing quality control processes and procedures over medical coding and claim submission
• Identify denial patterns among payors and establish guidelines for proper coding among company clients
• Identify denied codes to pursue for reconsideration and appeal
• Evaluates designated medical records to identify diagnoses, operations and procedures, and accurately confirms ICD-10 and/or CPT codes
• Reviews the accuracy and consistency of medical record documentation and brings any inconsistencies to the attention of the appropriate individual
• Ensure all claims are submitted with a goal of zero errors
• Sequence codes appropriately for accurate billing
• Reviews and verifies completeness and accuracy of all claims prior to submission
• Research and analyze data needs for reimbursement
• Communicates effectively with CHRMS and/or appropriate provider staff about coding issues, and resolves any discrepancies in accordance with applicable guidelines
• Assists with CHRMS Director of Billing to resolve coding edits, as needed
• Keeps current in area of expertise and assures that standards and practices reflect best practice in coding
• Recognizes and performs other duties which need to be performed although not directly assigned

Knowledge, Skills and Abilities:

• Ability to review patient charts and documentation to confirm CPT and ICD-10 codes as well as appropriate modifiers as required for billing and compliance.
• Strong understanding of medical terminology, anatomy and physiology
• Identify deficiencies in documentation and report to CHRMS Director and VP of Operations and/or providers as necessary
• Review charge submissions with exceptional attention to detail and ensure accurate charge capture
• Adheres to coding guidelines and regulatory requirements to ensure compliance with Federal, State and payor regulations

Education and Experience:

• High school diploma or equivalent
• Certification as a Medical Coder by AHIMA or AAPC
• Maintains current coding certification for ICD 10
• Minimum 5 years of medical coding/billing experience, Plastics, Neuro, Spinal, Orthopedic, Surgical coding experience, A PLUS
• Previous experience in EMR, Intergy, A PLUS

Salary and Benefits:

Starting at $31/hour and excellent benefits

EOE/DFWP

Pay: From $31.00 per hour

Expected hours: 40.0 per week

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person