Certified Medical Coder
GroupOne Healthsource Inc. - St. Louis, MO

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DESCRIPTION

The value this position brings to the company is submitting accurate claims to ensure claims are paid timely, to minimize claim denials and rejections and to provide an exceptional level of customer service and work product for every client.

Our coders act as a knowledge resource to other members of the billing staff to assist in the processing of medical claims in compliance with federal, state and local regulations.

We are seeking an experienced, certified medical coders to join our Coding team. Our ideal candidate will have strong problem solving skills, be self-motivated, and produce an exceptional level of work product.

Only applicants who meet the position requirements will be considered.

DUTIES

While solid coding skills are a must-have, the right candidate will also have the soft skills needed for this highly interactive role. Applicant will be responsible for handling incoming calls from clients, submitting claims and acting as a knowledge resource for client as well as coworkers. Applicant must be self-motivated, flexible, and must have basic PC software knowledge.

  • Reviews patient records for data quality and payment review processes,
  • Reviews electronic medical record documentation to obtain or verify diagnoses and procedures
  • Communicates as necessary with physicians to obtain or clarify diagnoses and/or procedures via the internal physician query process
  • Assigns accurate ICD-9 and CPT codes utilizing an electronic encoder application in accordance with practice policy and regulatory body guidelines
  • Submits insurance claims to the appropriate payors
  • Manage and maintains data files for multiple clients
  • Allocates payments for copayments received
  • Reviews and adjudicates Clearninghouse rejections daily
  • Assists with training of new coders, when needed
  • Acts as resource person for processing medical claims and provide in-service to the billing staff as requested by management
  • Completes department report(s) as requested
  • Provide in-service on coding issues to physicians and other clients of GOHS as requested by the Management of GOHS
  • Consult with clients on issues related to medical billing and coding as directed by Senior Management or the Regional Administrator.
  • Apply internal protocols regarding departmental communications.
  • Recommend new rules for Claims Scrubber
QUALIFICATIONS

  • High school diploma or equivalent
  • Certified Professional Coder
  • Minimum of 2 years medical coding experience beyond intern or externships
  • EMR/EHR experience required; eClinicalWorks specific knowledge is a plus but not required.
  • Knowledge of computer systems and software used in functional area
  • Knowledge of local, state and federal regulatory requirement related to the functional area
  • Knowledge of eCW software, functionality, usage, modules and applications is a plus but not required.
  • Capable of interpreting medical record reports, handwritten chart entries, and other related materials
  • Capable of applying judgment and making informed decisions
  • Confident in communicating complex concepts in simple form
  • Capable of to planning, organizing and working independently
  • Capable of managing, prioritizing and multitasking
  • Able to adapt to changing priorities
  • Skilled in reading and understanding an EOB
  • Skilled in fostering effective working relationships and build consensus with other departments and external vendors
  • Able to travel to client locations as needed
  • Able to sit for extended periods of time While solid coding skills are a must-have, the right candidate will also have the soft skills needed for this highly interactive role. Applicant will be responsible for handling incoming calls from clients, submitting claims and acting as a knowledge resource for client as well as coworkers. Applicant must be self-motivated, flexible, and must have basic PC software knowledge.
  • Reviews patient records for data quality and payment review processes,
  • Reviews electronic medical record documentation to obtain or verify diagnoses and procedures
  • Communicates as necessary with physicians to obtain or clarify diagnoses and/or procedures via the internal physician query process
  • Assigns accurate ICD-9 and CPT codes utilizing an electronic encoder application in accordance with practice policy and regulatory body guidelines
  • Submits insurance claims to the appropriate payors
  • Manage and maintains data files for multiple clients
  • Allocates payments for copayments received
  • Reviews and adjudicates Clearninghouse rejections daily
  • Assists with training of new coders, when needed
  • Acts as resource person for processing medical claims and provide in-service to the billing staff as requested by management
  • Completes department report(s) as requested
  • Provide in-service on coding issues to physicians and other clients of GOHS as requested by the Management of GOHS
  • Consult with clients on issues related to medical billing and coding as directed by Senior Management or the Regional Administrator.
  • Apply internal protocols regarding departmental communications.
  • Recommend new rules for Claims Scrubber

GroupOne Healthsource Inc. - 17 months ago - save job - block