Reports To: Revenue Cycle Director
Job Location: Remote
Hours/Week: 40 hours
Starting Salary: $28.00/hr - $33.00/hr
 

Position Summary

The practice provides physician services for trauma, emergent general surgery and surgical critical care. The Certified Coder is responsible for performing various duties to accurately interpret and bill physician charges for physician services in a hospital setting. Performs research and compliance with regulatory Coding requirements. Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors. Good working knowledge of medical terminology and anatomy required. Well versed in Accounts Receivable and familiar with various payers including CA Medi-Cal and Medicare.

Responsibilities

· Perform initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third-party payers.

· Interpret progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.

· Identify all billable procedures and services; ensuring all appropriate ICD, CPT, HCPCS code(s), and quantities are captured.

· Responsible for reviewing patient logs and other reports of clinical activity to ensure billing is captured for all patients.

· Review and resolve coding edits related to procedures and services charged.

· Perform weekly/monthly audits to ensure all services that can be billed are captured and coded for billing.

· Review all physician documentation to ensure compliance with third-party and regulatory guidelines.

· Maintain two-day coding turnaround times for procedure accounts based on date of service.

· Responsible for ensuring the batch processes for all coded charges.

· Identifies and escalates leadership impacts to timely coding, charge capture, and avoidable delays for billing/reimbursement.

· Evaluate medical records to identify documentation deficiencies and provides feedback to the clinicians.

· Queries physicians per established policy and procedure when documentation is not clear or conflicting.

· Provide clinicians with updates.

· Keep abreast of coding guidelines by self-study, assigned education, coding meeting attendance, or related in- services. Participates in internal and external quality review meetings and audits.

· Meet and/or exceeds the established quality standard of 97% accuracy rate or better while meeting and/or exceeding established production standards.

· Document and submit insurance appeals related to coding denials.

· Work closely with Accounts Receivables team members to answer all inquiries regarding coding and billing for physicians’ services.

· Perform special projects and other duties as assigned.

· Report to work, meetings, and professional obligations on time.

· Participate in administrative staff meetings and attend other meetings and seminars.

· Maintain confidentiality.

· Gather and interpret clinical data.

· Code and support corporate/department-specific quality standards and meet productivity standards as documented by the department and organization.

· Abide by the Standards of Ethical Coding set forth by the American Health Information Management Association (AHIMA) and adhere to all official coding guidelines.

· Attention to detail is crucial to this position.

· Manage time effectively and work in a high volume, high accuracy work environment with deadlines.

 

Lifts Weight or Exerts Force Work Environment

Employee may occasionally lift up to 20 pounds

 

Education and Experience

· High school diploma or equivalent.

· Coder certification from an accredited school.

· Certified Professional Coder with a minimum of two years experience with CPT/ICD-10 Coding of physician services required.

· Must have extensive knowledge of Trauma/Emergency Room and Surgical Coding for Professional Services and all official coding guidelines.

· Knowledge in Revenue Cycle department functions, including third-party billing and regulatory guidelines and requirements.

· Experience and proficiency with Epic and/or Cerner products.

· Intermediate to Advanced level in Microsoft Office.

· Advanced knowledge of hospital information systems, encoders, and other technology to facilitate a successful virtual work environment while maintaining maximum communication and adhering to HIPAA security standards.

· Technical skills required to learn and navigate various software systems, troubleshoot computer problems, install periodic updates to software programs, and work efficiently in a hybrid environment.

· Strong analytical skills and the ability to work independently on multiple tasks.

· Strong written and verbal communication skills.

· Familiarity with current healthcare-based technology, coding, and Electronic Health Record (EHR).