Accountable for conversion of diagnosis and treatment procedures into codes utilizing International Classification of Diseases and Operations, 9th Revision, Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT-4), Evaluation and Management (E&M), and HCPCS coding for Professional (Physician)l services received in the CMH Health Services system.
Requires skill in the sequencing of diagnosis/procedures to optimize reimbursement and compliance to documentation and medical policy guidelines for all payers.
Ensures that records are coded in an accurate and timely manner. Performs audits on chart information, level of care charged and provides education to staff and providers on compliant coding.
Duties, Tasks & Responsibilities:
Selects appropriate codes for reimbursement purposes; enters office and non-office charges slips into system; investigates and solves all claims questions - releasing the claim for submission;
Utilizes computerized coding/abstracting equipment, coding software and coding references and resources.
Understand medical/legal implications of incorrect coding and the responsibility of the certified coder to ensure coding accuracy.
Provides coding audits.
Provides one-on-one provider education about documentation and coding requirements.
Provides staff education and assists assigned providers with utilization of EMR for timely and compliant documentation as needed.
Reconciles charges against reports to ensure charges are captured.
Performs pre-certification requirements for medical tests / surgeries.
Performs other duties as assigned.
Qualifications: Knowledge, Skills, Abilities, Experience & Education
Associates Degree or equivalent combination of education and experience
Coding certification preferred; required within 1 year of hire
Physician billing experience preferred
Experience with insurance preferred
CPSI or Eclinical Works experience preferred
Knowledge of medical terminology
Excellent computer knowledge and data entry skills
See Physical Demands for lifting & other physical/environmental requirements.
Crawford Memorial Hospital - 7 months ago