Summary
The Medical Coder must have a good understanding of anatomy and physiology, the disease process, and clinical procedures in order to apply the correct codes that make up health records, claims and the business side of medicine.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
· Assign accurate medical codes for diagnoses, procedures and services performed in the endoscopy, hospital, and office settings using CPT, ICD-10-CM, and HCPCS Level II classification systems.
· Collect health information as documented by providers and code appropriately.
· Ensure that codes tally with provider diagnosis.
· Advocate for patients where their medical history is needed as evidence.
· Be updated about annual coding changes as set forth by CMS.
· Effectively query providers with coding questions.
· Review patients’ electronic medical records to verify the services provided and to ensure services are coded as specific and accurately as possible for timely reimbursement and to avoid claim denials.
· Apply coding rules and regulations along with proficiency on issues regarding compliance and reimbursement as well as medical necessity, claims denials, bundling issues and charge capture.
· Apply knowledge of coding systems’ corresponding guidelines and what codes are accepted by which insurance plans, which government and payer regulations to follow, and how to be compliant while coding.
· Correctly complete a CMS 1500 for facility services and UB04 for outpatient services, including the appropriate application of modifiers.
· Maintain confidentiality and privacy of patient and patient records.
· Attend staff meetings and participate in in-service programs to maintain and improve knowledge and skills.
· Perform other Billing department duties as needed.
Qualifications
- Certified Professional Coder (CPC) certification is required.
- Must have at least 3 years of medical coding experience.
- Gastroenterology medical coding experience required.
Competencies
· Teamwork Orientation
· Ethical Conduct
· Personal Effectiveness/Credibility
· Attention to Detail
· Patient Focus
· ADP experience
Supervisory Responsibility
This position has no supervisory responsibilities.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is sitting most of the day.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Work setting:
Experience:
- Medical Coding: 1 year (Required)
- Gastroenterology coding: 1 year (Required)
- pathology coding: 1 year (Required)
License/Certification:
- Certified Professional Coder Certification - CPC (Required)
Work Location: Remote