Certified Coder (FT)

Optim•Savannah, GA

About The Position

The Certified Coder obtains hospital dictation and charge slips from physicians, hospitals, transcription, and Athena for coding. The role updates physician coding according to payer guidelines and uses appropriate ICD-10 and CPT codes. It verifies and updates patient demographic information before posting charges, creates patient accounts when needed, and obtains demographic and authorization information from facilities. The position codes and posts charges accurately and promptly, including appropriate comments for global periods, codes, modifiers, and pricing. It completes missing slips, verifies surgical appointment posting, checks daily schedules and periodic missing-slip reports, and compares pre-certified codes with documentation. When code changes are needed, it obtains physician approval and coordinates updates with precertification staff and insurance carriers. The role also records and balances daily charges, handles Athena worklists and coding scrubs, reviews documentation, audits E/M documentation, and corrects charges across insurance carriers as needed. The Certified Coder assists other departments, offices, and patients with coding questions; maintains current knowledge of coding rules and legislative changes; maintains required accreditation or licensing and yearly Healthstream courses; and protects confidential information. Other related duties may be assigned.

Requirements

Maintain accreditation and/or licensing in the chosen field.
Complete yearly Healthstream courses.
Remain current with applicable coding rules and state and federal legislative changes affecting outcomes.

Responsibilities

Obtain hospital dictation and charge slips from physicians, hospitals, transcription, and Athena for coding.
Update physician coding in accordance with payer guidelines and use appropriate ICD-10 and CPT codes.
Verify and update patient demographic information before posting charges, create new patient accounts when required, and obtain demographic and authorization information from facilities.
Code and post charges accurately and promptly, including comments for global periods and correct codes, modifiers, and pricing.
Enter correct codes in all procedure fields to support accurate reporting and use multiple software programs to process coding.
Complete missing slips daily and verify that all surgical appointments are posted.
Print a daily schedule to ensure all cases are posted and periodically run Missing Slip Reports to verify monthly scheduled surgeries have been posted.
Compare pre-certified codes with documentation, notify providers when code changes are needed, and, upon physician approval, notify precertification staff to update codes with insurance carriers.
Ensure precertification or authorization is attached to claims.
Record and balance posted charges daily.
Assist departments, offices, and patients with coding questions, including questions about self-pay fees, down payments, and Medicare rates.
Post prepayments to surgery charges.
Handle Athena worklists and coding scrubs involving issues such as improper diagnoses, medical necessity, missing or incorrect modifiers, assistant surgeons, and appeals.
Review documentation and update coding to match the documentation.
Correct charges for other insurance carriers as requested and verified, including moving charges, payments, and adjustments.
Audit E/M documentation for all physicians and prepare various reports.
Remain current with state and federal legislative changes affecting outcomes and with applicable coding rules.
Maintain accreditation and/or licensing in the chosen field and complete yearly Healthstream courses.
Maintain strict confidentiality.
Perform related work as required.