Medical Coder

Role Overview

• Review physician dictation for office and hospital visits.
• Verify and make sure that the appropriate CPT/HCPC/ICD-10-CM codes have been chosen to ensure visit meets criteria for the level chosen.
• Post Co-Pay Payments when applied to encounters during coding.
• Review, code, and post charge for all events in NextGen (including Hospital, ASC, Clinic, and Radiology).
• Review and Correct ALL Coding Denials as needed and assigned in WorkLog (including Assisting Billing with Appeals as needed).
• Locate corrections or additions needed in dictation, and send requests to physicians and Transcription Department for necessary changes and or addendum.
• Answer questions on CPT/HCPC/ICD-10-CM codes needed by other departments.
• Work in conjunction with Pre-Coding, QA, and Back Office Staff to support, clarify, and charge for the physician’s treatment of each patient encounter.
• Follow through and complete missed charges on Unbilled Encounter Report (ie cast applications, DME’s, medications and injections, x-rays).
• Release claims after corrections are made or physician dictates as requested (i.e. x-rays, visits, medications, injections or casts).
• Know or learn to code per payer while remaining in AMA CPT guidelines.
• Attend continuing education to keep current with coding changes and third party payer requirements.
• Stay up to date on Coding/Payer Education via the Education Tracking Spreadsheet.
• Work closely with the Billing and Coding Manager and Supervisors to interpret third party payer requirements.
• Assist to implement procedures that ensure optimum reimbursement in compliance with regulations.
• Develop and implement improvements as appropriate.
• Provide excellent customer service to staff, leadership, providers and customers.
• Assist in maintaining and monitoring department spreadsheets and WorkLog as assigned.
• Support other departments company wide in correct understanding and usage of CPT/HCPC/ICD-10-CM codes.
• Assist in the Annual Provider Reviews for your assigned physicians.
• Participate in quarterly Q&A sessions.
• Assist with other duties as assigned.
• Assist other departments in understanding and interpreting LCD policies published by CMS.
• Assist Pre-Auth Department with CPT/HCPC/ICD-10-CM codes as needed.

Requirements

• Medical coding certification from AAPC (CPC-A or CPC) or AHIMA (CCA, CCS-P) must be obtained prior to hire.
• Minimum 1 year of experience in the last 18 months in coding physician services and/or physical therapy (PT/OT) services preferred.
• Knowledge of Medicare provider requirements preferred.
• Excellent communication skills.
• Microsoft Office Knowledge including Outlook, Excel, Word, Power Point and OneNote.
• Basic computer skills; Microsoft Office Suite.
• Ability to speak, read, write and listen to the English language without translation.

Benefits

• Competitive Benefit Package: Competitive pay, health, dental, paid time off, paid holidays, 401(k) with company match, profit-sharing, employee discounts and more.