What are the responsibilities and job description for the Certified Coder position at Columbia Valley Community Health?
Overview
The Coder’s primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record.
***MUST APPLY AT CVCH.ORG***
Duties
1. Reviews clinical encounters presented via electronic lists to ensure proper submission of services prior to billing.
a. Edits and corrects diagnosis and procedural codes and applies modifiers and CCI edits as required according to coding guidelines and department policy.
b. Effectively utilizes coding software and/or books to confirm coding accuracy.
c. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding.
2. Receives and reviews paper fee slips for hospital services and ensures proper coding of diagnosis and procedural codes.
a. Applies modifiers and CCI edits as required and supported by the documented medical record. Posts charges for final billing.
b. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding.
3. Utilizing approved methods, communicates incorrect application of procedure or diagnosis codes or incomplete medical documentation to providers.
a. Reports all unresolved non-compliant coding issues immediately upon discovery, as dictated by department or organizational policy.
b. Works with providers and clinical support staff to resolve coding and documentation concerns.
4. Meets on a regular basis with providers and clinical staff (for their assigned specialties) for the purpose of educating them on coding rule changes and/or coding trends and to answer coding questions
a. Participates with educational activities with clinical departments, corporate compliance, etc. to ensure lines of communication among departments remains open and positive.
5. Is responsible to remain current with general billing guidelines, reimbursement rules and regulations.
a. Is responsible to remain current with their specific guidelines by reading payer publications and reviewing their websites.
b. Understands FQHC billing nuances to ensure accurate coding and maximum reimbursement for related services.
c. Attends conferences, seminars and webinars as requested to remain current on billing related policies.
6. Other responsibilities may include:
a. Provides information as needed for production reporting and to ensure job standards are consistently met or exceeded.
b. Assists with internal audits by providing requested information and participating in review finding discussions regarding insurance processing performance. Submits to remedial training if substandard performance is identified through such audits.
c. Assists co-workers and management with special projects related to claims or A/R clean- up efforts.
d. To ensure uninterrupted service, participates in cross-training efforts and provides coverage for insurance processing and follow-up needs with non-assigned payers.
e. Actively participates in departmental and/or organizational process improvement (lean) initiatives.
f. Notifies management of audit requests by insurance payers and complies with requests in a timely manner.
Skills
- AAPC Certification (American Academy of Professional Coders).
- Strong understanding of medical terminology
- Experience with EMR/EHR systems used for documentation and coding purposes.
- Knowledge of medical billing processes and medical collections procedures.
- Familiarity with medical records management and healthcare compliance standards.
- One year of coding experience in a healthcare setting preferred. Strongly prefer knowledge of diagnosis and procedural coding, medical terminology and insurance billing guidelines, fluent with industry X12 and ANSI guidelines, proficient with claims adjustment reason and remark codes (CARC and RARC), FQHC certification or billing experience.
- English required.
- Position eligible for Partial Telecommuting
Job Type: Full-time
Pay: $23.58 - $35.70 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
Salary : $24 - $36