Certified Medical Coder (24-086)

Description

Job Summary:

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:

Ø Education - High School Diploma/GED or higher

Ø Work Experience – Preferred 2+ years of post-certification medical coding experience

o Experience with various encoder systems (3m, Knowledge source, Encoder Pro, Evident, etc.)

Ø Training - Experience with CPT-4/HCPCS Procedure coding

o Experience with ICD-10-CM coding

o

Ø 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

o All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview/offer process

o 2+ years of experience in a PC in a Windows environment, including MS-Excel and EMR systems

o Proficient Excel skills

o Medical terminology knowledge

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