Certified Coder - Remote

Optim•Savannah, GA

4d•Remote

About The Position

This role is responsible for obtaining dictation and charge slips from various sources to accurately code medical services using ICD-10 and CPT codes. The position involves verifying and updating patient demographic information, creating new patient accounts, and obtaining necessary authorization details. A key responsibility is the accurate and timely coding and posting of charges, ensuring correct modifiers, pricing, and tracking for reporting. The role also includes managing missing slips, verifying surgical appointments, and running reports to ensure all cases are posted. Additionally, the Certified Coder will compare pre-certed codes with documentation, notify providers of necessary changes, and ensure all claims have proper pre-certification or authorization. The position requires recording and balancing posted charges daily, assisting other departments with coding inquiries, and handling various coding issues within the Athena worklist. This includes correcting charges for different insurance carriers, auditing E/M documentation, and staying current with legislative changes affecting coding. Maintaining accreditation, licensing, and completing yearly courses are also essential duties. The role demands strict confidentiality and performing related tasks as required.

Requirements

Proficiency in ICD-10 and CPT coding.
Experience with Athena software.
Ability to access and utilize multiple software programs.
Knowledge of payor guidelines.
Understanding of medical necessity, modifiers, and assistant surgeon coding.
Familiarity with state and federal legislative changes affecting coding.
Ability to maintain accreditation and/or licensing.
Completion of yearly courses for Healthstream.
Strict adherence to confidentiality.

Nice To Haves

Experience with hospital dictation and charge slip processing.
Experience with pre-certification and authorization processes.
Experience auditing E/M documentation.

Responsibilities

Obtains hospital dictation and charge slips from physicians/hospital/transcription/Athena to code.
Updates physician coding as appropriate to payor guidelines.
Utilizes proper ICD-10 and CPT codes.
Verifies and updates all patient demographic information before posting charges on patient accounts.
Creates new patient accounts when required.
Obtains demographic and authorization information from facilities.
Codes and posts charges accurately and timely, including comment entries for global period, correct codes with proper modifiers and pricing.
Ensures correct coding in all procedure entry fields for accurate tracking.
Accesses multiple software programs for processing accurate coding.
Completes missing slips daily and verifies posting of all surgical appointments.
Prints a daily schedule to ensure all cases are posted.
Runs Missing Slip Report periodically to verify all scheduled surgeries posted for the month.
Compares pre-certed codes to documentation and notifies providers to authorize code changes.
Notifies precert staff to change codes accordingly with various insurance carriers upon physician approval.
Ensures all have precert/authorization attached to claims.
Records and balances all posted charges daily.
Assists with coding questions from other departments, offices, and patients.
Provides fees for self-pay patients/down payments/Medicare rates.
Posts prepays to surgery charges.
Handles Athena worklist/scrubs on various coding issues such as improper diagnosis, medical necessity, missing or incorrect modifiers, assistant surgeons, appeals, etc.
Reviews documentation to update coding as documented.
Corrects charges to other insurance carriers as requested and verified, including moving charges, payments, and adjustments.
Audits E/M documentation for all physicians.
Generates various reports.
Remains current with state and federal legislative changes that affect outcomes.
Maintains accreditation and/or licensing in chosen field.
Maintains yearly courses for Healthstream.
Maintains strictest confidentiality.
Performs related work as required.