Job Summary

The Certified Coder is responsible for working with clients to achieve ongoing Revenue Cycle Performance/Management, customer reporting and satisfaction. The Coder is responsible for accurate coding of all visits and surgeries, acting as a resource to the client as well as the accounts receivable team for coding related denials.

Qualifications

  • CPC Certification through AAPC or AHIMA, Required
  • In depth knowledge of clinical workflow
  • Expert in Microsoft Office products, including Word and Excel
  • Must have the ability to do production level coding
  • 3 Years specialty specific coding experience
  • Training experience preferred
  • Expert experience with CCI edits
  • Revenue Cycle Management (RCM) experience required
  • Denial management and appeals experience, preferred
  • Strong verbal and written communication skills
  • Ability to pass medical coding assessment
  • COSP preferred

Responsibilities

  • Perform medical record review with the purpose of coding CPT and ICD level coding
  • Trains providers and/or coding staff on the usage of platforms for charge capture purposes
  • Works with the Education Supervisor on system updates and creates/coordinates ongoing training to providers and staff as required
  • Assists as needed with the creation of ICD-10 CM, CPT/HCPCS coding rules and pick lists for providers
  • Responsible for initial and ongoing education of all care providers on key revenue cycle topics, including but not limited to ICD-10 CM, CPT/HCPCS and E/M coding, documentation, billing policies and regulatory compliance
  • Ensures the accuracy of documentation is maintained through the analysis of coded data
  • Provides re-education and training of providers if accuracy of the documentation is not maintained. Analyzes and trends data to identify areas of opportunity related to documentation and coding.
  • Educates providers regarding correct documentation per CMS guidelines to ensure the organization is billing appropriately
  • Conducts concurrent coding reviews for newly hired providers and coding staff
  • Provides timely feedback to management
  • Assists with the development of training and educational materials as needed to address documentation and coding deficiencies.
  • Coordinates schedules and conducts new hire education and training.
  • Interacts closely with the providers in education for documentation or coding purposes due to conflicting documentation, clarification of documentation through query process.
  • Reviews platform upgrades and creates revised departmental documentation when necessary
  • Reports system issues as they relate to coding functions and assists with resolving complexities in training workflow
  • Stays current on coding updates and communicates changes to providers and coders in a timely manner
  • Works closely with management to identify denials and develops education that will minimize future claim rejections as they pertain to medical necessity and coding errors
  • Understands and applies Medicare billing rules (i.e., LCD/NCD/CCI)
  • Advanced Proficiency with MS-Excel, Word, and PowerPoint
  • Account for internal control responsibilities in line with the organization’s objectives
  • Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA)
  • Perform other Account management duties as requested or assigned

 

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