Certified Coder I

Best Care•Omaha, NE

1d•Onsite

About The Position

This position reviews Current Procedural Terminology (CPT) procedure codes and CPT charge codes to ensure all accounts reflect appropriate charges for services provided by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account. The role involves coding professional charges and/or hospital services to ensure accurate billing by reviewing doctor dictation and assigning CPT and ICD-10-CM codes. It also ensures timely submission of claims to insurance companies by performing job functions and maintaining Accounts Receivable within 3-5 days of discharge on all outpatient encounters. The coder will assign appropriate E/M Current Procedural Terminology (CPT) code into the coding abstract following CPT coding and 1995/1997 E/M guidelines. Additionally, the role involves reviewing hospital billing charges with physicians to ensure accuracy, investigating claim denials from third-party payers, and reviewing Medicare and Commercial correspondence for updates, updating the coding manual when necessary.

Requirements

High School Diploma or General Educational Development (G.E.D) required
College level completion of courses in anatomy and physiology, biology, disease process, and medical terminology required.
Certification as Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) or registration as Registered Health Information Tech (RHIT) required.
N/A

Nice To Haves

Associate's Degree in Health Information Management or healthcare related degree preferred.
Prior healthcare registration, customer service, insurance or billing experience preferred.

Responsibilities

Codes professional charges and/or hospital services to ensure accurate billing by reviewing doctor dictation and assigning CPT and ICD-10-CM codes.
Ensures timely submission of claims to insurance companies by performing job functions #1 by maintaining Accounts Receivable within 3 - 5 days of discharge on all outpatient encounters.
Maintains a minimum productivity standard of: Codes 30 Radiology/OP Diagnostic services encounters per hour. Codes 25 Non-patient Pathology Encounters per hour. Codes 15 Recurring encounters per hour. Codes 15 Emergency Department encounters per hour. Codes 12 Professional Services encounters per hour. Codes 10 GI Lab and Pain Management encounters per hour.
Assigns appropriate E/M Current Procedural Terminology (CPT) code into the coding abstract following CPT coding and 1995/1997 E/M guidelines on Clinic encounters, Professional inpatient initial and subsequent hospital visits, or ED encounters.
Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates.
Investigates claim denials from third party payers to ensure accuracy by reviewing services patient received and patient account and making any coding/charging corrections.
Reviews Medicare and Commercial correspondence for updates by checking for billing and coding changes. Updates coding manual when necessary.