Coder

GENERAL SUMMARY OF DUTIES:

• Verifies and audits per tickets.
• Checks for correctness and completeness prior to tickets being processed for billing, insurance filling and revenue reporting.
• Monitors daily flow of fee tickets to ensure accuracy and timeliness of output.
• Communicates to physicians when services are denied due to coding errors.
• Responsible for verifying and updating demographic information on services performed outside of Clinic.

TYPICAL PHYSICAL DEMANDS:

• Requires sitting/standing for long periods of time using a computer terminal and telephone.
• Some bending and stretching required.
• Occasional lifting up to 40 pounds.
• Working under stress.
• Requires manual dexterity sufficient to operate a keyboard, telephone, copier, fax and such other office equipment as necessary.
Vision must be correctable to 20/20 and hearing must be within normal ranges.

EXAMPLE OF DUTIES AND RESPONSIBILITIES:

• To properly update patient demographic information for services rendered outside of the physician’s office and verify correct insurance is entered into the Clinic Computer system promptly and accurately.
• To review services rendered by physicians and determine:
  • A. If modifiers need to be added
  • B. If operative report should be attached to the claim
  • C. If correct coding of procedure for Medicare Patients properly represents a payable diagnosis based on Medicare Medical Policy and if it does not, to communicate this discrepancy to the physicians.
• To ensure all services rendered by Elkhart Clinic Physicians are entered into our billing system in a timely and accurate fashion and if none received, to follow up with the physician in a timely manner.
• To follow up with the Collections Department and communicate with them services entered into Clinic Computer System for patients who have health insurance coverage.
• Perform other duties as assigned.

KNOWLEDGE, SKILLS, ABILITIES:

• Working knowledge of Insurance claims process including CPT and ICD-10 coding.
• Telephone etiquette.
• General understanding of insurance processing and policies, which govern these plans.
• Ability to operate computer, ten key adding machine, various printers, forms, and telephones.
• Ability to type 35 wpm. Ability to maintain confidentiality.
• Ability to be a team player.

EDUCATION:

• High School diploma or GED

EXPERIENCE:

• Experience in coding practices, including one-year medical coding experience or equivalent training.

CERTIFICATE/LICENSE:

• Certified Medical Coder preferred.