Overview

The Coder works in direct support of all clinical programs, ensuring professional physician services are properly coded prior to billing.

Responsibilities

• Review patient documents for proper CPT, CPT Category II codes, ICD-10-CM code assignments, and quality reporting measures such as HEDIS.
• Review records to ensure all required information is present for billing, reimbursement, and regulatory compliance purposes.
• Communicate effectively with providers to ensure documentation supports reported codes.
• Report documentation and compliance concerns to Lead Coder and Business Services Manager.
• Serves as a resource regarding resolution of insurance denials and coding questions presented by A/R management personnel, residents, and providers.
• Meet coding production expectations.
• Participate in data collection, abstraction, and other reporting.

SUPERVISORY RESPONSIBILITY

No supervisory responsibility.

WORKING ENVIRONMENT/PHYSICAL DEMANDS:

General office environment-hybrid remote opportunities available, requiring computer usage (prolonged sitting, eye strain).

TRAVEL

No travel required.

Qualifications

• 5 years coding experience with medical coding certification, RHIT, AAPC or AHIMA and or/ 5 years coding experience with enrollment in certification course within the first year of employment. Required
• Extensive knowledge of CPT, HCPCS and ICD-10-CM code assignment. Required
• Working knowledge of Electronic Health Record and Computer proficiency. Required
• Experience coding for professional services and multi-specialty clinic setting. Preferred
• Medical billing experience. Preferred
• Epic System EHR experience. Preferred

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, activities may change at any time with or without notice.