CERTIFIED CODER

ESSENTIAL FUNCTIONS:

• Consistently and accurately assigns ICD-10-CM, CPT and/or HCPCS codes in accordance with current year CMS/AMA CPT-4, HCPCS and Official ICD-10 Coding Guidelines by reviewing and interpreting medical documentation from physician office visit notes, procedure notes, nurse visit notes, provider orders, pathology, labs, etc.
• Identifies and abstracts any additional documented HCC diagnosis not listed by the provider in the Assessment/Impression/Final Diagnosis
• Review and report missing or incomplete documentation
• Query providers or clinic staff as necessary for clarification of documentation or lack thereof as it pertains to proper application of ICD-10-CM diagnosis coding, HCPCS and CPT E/M and procedure coding
• Monitor assigned work lists and provider lists to ensure all records are coded in a timely manner
• Meets departmental productivity standards for coding
• Maintain current knowledge of medical compliance, coding guidelines and federal regulations, such as medical necessity issues and correct coding initiatives
• Keep informed of the changes/updates in ICD-10-CM/CPT guidelines by attending appropriate training, review coding clinics and other resources and implementing these updates in daily work
• Meet continuing education requirements for coding certification
• Maintain annual compliance education
• Participate in coding meetings and education conferences to maintain coding skills and accuracy
• Attend conference calls as necessary to exchange information related to Coding

ADDITIONAL RESPONSIBILITIES:

• Ability to manage significant workload, and to work efficiently under pressure meeting established deadlines with minimal supervision
• Consistently demonstrates time awareness, reduces non-essential interruptions to an absolute minimum
• Demonstrates thorough understanding of how position impacts the department, clinics, and hospital
• Demonstrates a good rapport and works to establish cooperative working relationships with all members of department, clinic, and hospital staff
• Assists billing office staff with claims denials. Verify accuracy of billing data and make corrections as appropriate for re-billing purposes as needed
• Performs special projects as directed by Supervisor
• Identify and communicate trends and educational opportunities to ensure proper documentation, coding, and accuracy of billing
• Respond to inquiries from providers, staff, and management in a timely and professional manner
• Organized and completes tasks
• Regular and reliable attendance
• Responsible and dependable
• Present to work on time as scheduled
• Strong communication skills, oral and written with a friendly, helpful attitude
• Strong work ethic and flexibility required
• Analytical skills experience and sound judgment to make decisions
• Self-motivated problem-solver with professional demeanor
• Must be able to seek assistance from supervisor when any change in schedule or issues with assigned work arise
• Ability to use whatever tools and equipment is available to get the job done
• Knowledgeable in multiple computer programs, i.e., Microsoft Outlook, Excel, Word
• The ability to work with little to no supervision
• Perform other duties as assigned by supervisor

KNOWLEDGE/SKILL/ABILITIES:

AGE-RELATED COMPETENCIES: Demonstrates the basic knowledge and skills necessary to identify age-specific patient needs appropriate for this position.

INFORMATION MANAGEMENT: Treats all information and data within the scope of the position with appropriate confidentiality and security.

RISK MANAGEMENT/QUALITY MANAGEMENT/SAFETY: Cooperates fully in all Risk Management, Quality Management, and Safety Activities and Investigations.

MINIMUM POSITION QUALIFICATIONS:

• Education - High School Diploma/GED or higher
• Work Experience – Preferred 2+ years of post-certification medical coding experience
  • Experience with various encoder systems (3m, Knowledge source, Encoder Pro, Evident, etc.)
• Training - Experience with CPT-4/HCPCS Procedure coding
  • Experience with ICD-10-CM coding
• License/Certification - Professional coder certification with credentialing from AHIMA and/or AAPC (CPC-a, RHIT, RHIA, CCA, CPC, COC, CPC-P, CCS) to be maintained annually
  • All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview/offer process
  • 2+ years of experience in a PC in a Windows environment, including MS-Excel and EMR systems
  • Proficient Excel skills
  • Medical terminology knowledge

ENVIROMENTAL CONDITIONS: Work environment consists of daily patient contact, which may include exposure to blood, or other body fluids.