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Certified Coder

Category

Position Control #

# 09-5027-547

Status

Location(s)

ROLES AND RESPONSIBLITIES:
  • Audit records to ensure proper submission of services prior to billing on pre‐determined selected
    charges and track errors in the Coding Department folder on the S drive‐Coding Department‐Audits‐Daily Claims Audits ‐ “Insurance Audited name”.
  • Creates spreadsheets to track coding errors and corrections in the Coding Department folder on the S drive‐Coding Department‐Audits‐ Daily Claims Audits‐ Provider Error Reports‐20XX
  • Audit medical records to ensure proper coding is complete and concise as well as to ensure compliance with federal and state regulatory bodies
  • Based on audit results, contact Clinicians to train and update them with correct coding information
  • Effectively Communicate/correct/apply ICD‐10‐CM, CPT and HCPCS codes on claims.
  • Attends seminars and in‐services as required to remain current on coding issues.
  • Work with billing department to identify possible complex coding opportunities
  • Submit statistical data for analysis and research by billing departments
  • Conducts clinical orientation training on a by‐weekly basis to welcome incoming clinicians
  • Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct.
  • Reports compliance problems to the Director of Certified Coding.
  • Accurately follows coding guidelines and legal requirements to ensure compliance with federal and
    state regulatory bodies
  • Maintain and report new ICD‐10‐CM, CPT and HCPCS codes on a yearly basis for training and reporting
    with staff
  • Analyzes provider documentation to assure the appropriate, ICD‐10‐CM, CPT, HCPCs and Evaluation & Management (E&M) codes are assigned using the correct codes
  • Monitor and educate Coding and Revenue Cycle staff to ensure all FCHC policies and procedures are
    being adhered to.
  • Review claims and charts with chronic conditions for possible errors in coding and the need for any Risk Adjustment corrections and build training based on findings for all responsible staff.
  • Train Coding and Revenue Cycle staff on proper coding/denial resolution and claim correction per insurance billing requirements and HEDIS/Quality requirements.
  • Set goals for performance and deadlines with Coding and Revenue Cycle staff in ways that comply with company’s plans and vision and communicate them to subordinates.
  • Monitor Coding and Revenue Cycle staff for accuracy and completeness of claims corrections and submission
QUALIFICATIONS AND EDUCATION REQUIREMENTS:
  • Associates Degree in management or equivalent experience preferred.
  • Four (4) years’ experience using ICD‐10‐CM, CPT, HCPCs, or its equivalency.
  • Medical Coding Certificate ‐ CPC, CCS‐P or RHIT certification is required.
  • Must have excellent interpersonal skills and is able to communicate effectively.
  • Must be proficient in: Microsoft Excel, Word and PowerPoint.
  • Must be able to review, and interpret medical records with minimum assistance from providers.
  • Must be able to analyze data and report it effectively.
  • Must have working knowledge of medical terminology and anatomy.
  • Must have knowledge of HCC and Risk Adjustment scoring.
  • Must have OB/GYN Coding and Billing knowledge.
  • Must be able to communicate and train effectively.
  • Must be able to travel to Centers when required.
  • Proven experience as supervisor or relevant role.
ADDITIONAL NOTES:
THIS JOB DESCRIPTION IS NOT INTENDED TO BE ALL‐INCLUSIVE, AND EMPLOYEE WILL ALSO PERFORM OTHER REASONABLE RELATED BUSINESS DUTIES AS ASSIGNED BY SUPERVISOR.
*This organization reserves the right to revise or change job duties and responsibilities as the need arises. This job description does not constitute a written or implied contract of employment.
Applicant Name(Required)
Are you willing to travel to different centers?(Required)
Accepted file types: pdf, docx, doc, rtf, txt, Max. file size: 8 MB.
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