Assoc Professional Services Coder

Position Purpose:

To be responsible for accurately translating patient information into alpha-numeric medical codes using patient treatment, health history, diagnosis, and related information.  This information is then submitted to various insurance companies for medical services reimbursement.   Additionally, this position reviews select portions of patient medical records  to ensure correct billing and compliance  and to verify medical data with physicians. 

Nature and Scope:

Incumbents must be proficient with CPT and ICD-9-CM coding systems and are responsible for assigning ICD-9-CM diagnoses codes and CPT procedure codes accurately and completely to ensure optimal reimbursement and coding quality. Coders in this position are held accountable for adhering to coding guidelines; and, accounts must be coded within timeframes specified by department leadership.

 Incumbent is responsible for coding/auditing encounters in the EMR system   In addition, must be willing to provide help where needed to assist the team in meeting its daily/weekly/monthly goals.  Incumbent responsibilities include completion of accountable workques related to daily unbilled charges to ensure timely coding/billing and compliance. This position is challenged to stay abreast of the frequent changes in Federal and State regulations for professional fee billing and coding, stay informed of changes in treatment modalities and new procedures codes, and to request physician clarification of diagnosis and/or procedures when physician documentation is vague and/or missing.

KNOWLEDGE, SKILLS & ABILITIES

1.       Knowledge of ICD9-CM, CPT and Level I HCPCS coding.

2.       Knowledge of Evaluation and Management Guidelines and auditing to assist in provider education and identifying possible revenue opportunities.

3.       Conversion of written description to proper billing codes.

4.       Ability to appeal CPT and ICD-9-CM for maximum reimbursement.

5.       Comprehension of disease processes.

6.       Ability to work well with others.

7.       Medical Records content standards.

8.       Philosophy consistent with Standards of Conduct.

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications:  Requirements - Required and/or Preferred

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English. Associates Degree preferred.

Experience:

A minimum of one (1) year previous coding experience and/or two (2) years of billing preferred.

License(s):

None.

Certification(s):

 None.

Computer / Typing:

Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.