DescriptionJob 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 supervisorKNOWLEDGE/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 higherØ Work Experience - Preferred 2+ years of post-certification medical coding experienceo Experience with various encoder systems (3m, Knowledge source, Encoder Pro, Evident, etc.)Ø Training - Experience with CPT-4/HCPCS Procedure codingo Experience with ICD-10-CM codingoØ 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 annuallyo All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview/offer processo 2+ years of experience in a PC in a Windows environment, including MS-Excel and EMR systemso Proficient Excel skillso Medical terminology knowledgeENVIROMENTAL CONDITIONS: Work environment consists of daily patient contact, which may include exposure to blood, or other body fluids.
