Coder I – Revenue Assurance Capture Specialist

Role Overview

• Assigns codes based on clinical documentation to office-based visits including procedures utilizing International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)
• Adheres to the organization and departmental guidelines, policies and protocols
• Sequences diagnoses and procedure codes as outlined in CPT, ICD and HCPCS Coding Guidelines while adhering to local and national governmental payer guidelines
• Reviews all clinician documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes
• Follow up and obtain clarification of inaccurate documentation as appropriate
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines
• Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement
• Maintains the confidentiality of patient records
• Reports any perceived non-compliant practices to the coding leader or compliance officer
• Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable

Requirements

• Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)
• Advanced training beyond High School in Medical Coding (or equivalent knowledge)
• Typically requires 1 year of related experience
• Knowledge of ICD, CPT and HCPCS coding guidelines
• Knowledge of medical terminology, anatomy and physiology
• Basic computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short
• and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program
• Opportunity for annual increases based on performance