General Summary
The Coder is responsible for ensuring appropriate levels of service are being billed according to documentation and 1995 billing guidelines, insurance credentialing and provider/staff education in relation to billing guidelines.
Maintains routine chart audits for providers.
Essential Duties and Responsibilities
Assigns ICD-9-CM, CPT, and HCPCS Level II codes to completed, signed medical documentation creating an appropriately assigned medical claim.
Abstracts specified data and information from patient records in order to determine appropriate modifiers for claim submission.
Queries providers for clarification of documentation when unclear or inadequate in order to code accurately.
Requests providers to complete addendums as necessary.
Stays up-to-date with CMS and other federal, state, local, and Phelps Health-specific coding guidelines, rules, and regulations.
Abides by AAPC’s “Standards of Ethical Coding”.
Applies CMS and AAPC approved Coding Guidelines to all types of patient accounts.
Monitors providers documentation for timely completion.
Notifies Coding Team Leader of any providers who fall outside the designated 72 hour turn around time frame.
Maintains the designated 3 business days time frame for coding completed records and provides weekly report summaries to Coding Team Leader.
Maintains annual certification thru AAPC and competes required CEU for certification.
Job Qualifications
Education
High school diploma or equivalent required.
Work Experience
Minimum 1 year medical coding experience or appropriate schooling is preferred.
Certification/License
Certification or registration as a medical coder required.
Current driver’s license and declaration of automobile liability insurance.
Mental/Physical Requirements
Considerable mental concentration for sustained periods of time with attention to detail of paramount importance.
Pressures of time, accuracy, and interruptions.
Must handle confidential material.
Long periods of sitting is required.
Must be able to handle and transport 5-10 lbs.
of charts for short periods of time.
Standing, walking, reaching, bending, and stooping.
Vision must be good.
Must have finger dexterity and complete use of hands and arms.
Approximately 80% of working time is spent at a computer.
Must have great customer service skills and the patience to deal with difficult situations.
Working Conditions
Standard office conditions; clean, well lit, climate controlled environment.
Location: Phelps Health · Medical Group Business Office-Coding
Schedule: Full-time, Day shift, 7a - 4:30p
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