What are the responsibilities and job description for the Ambulatory Surgical Center Coder (Certified) position at External Brand?
ABOUT AUSTIN REGIONAL CLINIC:
Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35 locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit https://www.austinregionalclinic.com/careers/
PURPOSE
Responsible for abstracting and coding Ambulatory Surgery services for a range of surgical procedures using ICD-10-CM, CPT-4, HCPCS and other applicable classification coding systems. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.
ESSENTIAL FUNCTIONS
- Abstracts and ensures accuracy of diagnoses, procedures, patient demographics and other required data for charge entry.
- Thoroughly reviews patient medical records, surgical reports and physician notes to ensure all procedures are documented correctly.
- Understands and follows implant charging and coding.
- Performs charge entry functions.
- Using reports, audits fee tickets in charge review work queue for completeness and accuracy.
- Informs the ASC facility manager of conflicting or ambiguous information in the medical record prior to submitting charges.
- Assists facility and physicians with coding questions or concerns.
- Facilitates conversation and works as a liaison between CBO, Compliance, and ASC to resolve billing concerns such as claim denials and patient billing.
- Assists in writing appeals for denials.
- Serves as a resource for other ASC office staff.
- Performs regularly scheduled targeted audits to assess revenue optimization and quality of documentation.
- Participates in development and maintenance of all charge entry work queue edits.
- Researches and resolves problems with patient account related inquiries in work queues.
- Follows workflows consistent with the policies of the Compliance Plan.
- Supports compliance policies with government and private payer regulations.
- Adheres to all company policies, including but not limited to OSHA, HIPAA, compliance, and Code of Conduct.
- Follows the core competencies set forth by the Company, which are available for review on ARC SharePoint.
OTHER DUTIES AND RESPONSIBILITIES
- Obtains insurance eligibility and benefit details.
- May review records for completeness, accuracy and compliance with regulations.
- Works with the providers to communicate coding issues and submit adjustment journals as needed.
- Performs other duties as assigned.
QUALIFICATIONS
Education and Experience
Required: High school diploma or GED. Two (2) or more years of experience in Ambulatory Surgery coding, auditing and clinical information systems.
Preferred: Associate’s or bachelor’s degree preferred.
Certificate/License
- Must maintain Certified Professional Coder or other AAPC coding certification
- Must attend and complete all work queue training and successfully pass all tests based on the guidelines listed in the Compliance Plan.
Knowledge, Skills and Abilities
- Excellent verbal and written documentation and communication skills.
- Knowledge of medical terminology.
- Familiarity with procedural and diagnostic coding.
- Familiarity with ICD and CPT coding methodology.
- Knowledge of medical insurance, collections, and appointments.
- Excellent customer service skills.
- Excellent computer and keyboarding skills, including familiarity with Windows.
- Excellent interpersonal and problem solve skills.
- Ability to work in a team environment.
- Ability to manage competing priorities.
- Ability to engage others, listen and adapt response to meet others’ needs.
- Ability to perform job duties in a professional manner at all times.
- Ability to align own actions with those of other team members committed to common goals.
- Ability to understand, recall, and communicate, factual information.
- Ability to understand, recall, and apply oral and/or written instructions or other information.
- Ability to organize thoughts and ideas into understandable terminology.
- Ability to apply common sense in performing job.
Work Schedule: Monday- Friday 8am-5pm
