Certified Professional Coder (CPC): Surgical and Consultation Services

Location: Geneva, IL (On-Site)

Status: Full-time (40 Hours/Week)

Days/hours: Monday - Friday

Salary Range (based on experience): $20-$22/hr

Summary

This position reviews, analyzes and assures the final diagnosis and procedures as stated by the practicing providers are valid and complete. Accurately code procedures for providers to ensure proper reimbursement. Responsible for coding, chart compliance, auditing and collections support.

Essential Duties and Responsibilities

The essential duties and responsibilities include the following. Other duties may be assigned.

• Interpret operative reports for all healthcare providers and services and translate interpretation into CPT, ICD-10 and HCPCS codes.
• Pre-code surgical procedures after reviewing the “surgery order” for the surgeon’s intended procedure.
• Code operative and consultation reports and enter codes in the EHR (Athena), based on case policies set by payors.
• Create and submit claims for professional, surgical assist, and facility fees where appropriate, for consultations and surgeries after provider sign-off.
  • This includes ensuring correct insurance is ‘set,’ and prior authorizations or precertification numbers are referenced.
• Upload and input external, supportive documents (i.e. operative reports, consult reports, hospital progress notes, facesheets) into patients’ charts when necessary, in order to submit claims successfully.
• Communicate with providers on coding questions as necessary.
• View Nightline dictations when necessary to capture missed consultation or surgery charges.
• Monitor and manage appropriate assigned Athena worklists to correct claims that, after submission, fall into a hold status due to a coding issue, prior to being submitted to payor.
• Collaborate with members of the Revenue Cycle teams, specifically Patient Account Specialists, on corrected claims involving coding issues when necessary.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education and/or Experience

• High School Graduate or GED.
• Current Certified Professional Coding Certificate.
• At least 2 years of healthcare procedure entry - orthopedics preferred.
• Understanding of CPT, ICD-10, HCPCS coding required.
• Understanding of medical terminology and anatomy.
• Ability to use a personal computer.
• Experience with Word and Excel preferred.
• Experience with Athena EHR, preferred.