Certified Medical Coder II CPC

Mount Sinai Medical Center•Miami Beach, FL

3d•Onsite

About The Position

Florida residency required. This role applies expert knowledge of ICD‑10‑CM, CPT, and HCPCS coding to accurately code inpatient and outpatient encounters in compliance with AMA and CMS guidelines. The position involves reviewing clinical documentation for medical necessity, resolving coding and billing issues, supporting charge capture and denial prevention, and collaborating with providers to ensure accurate, compliant reimbursement.

Requirements

Florida residency required
CPC or CCS-P Certification Required
High School graduate
Five plus years experience in Coding and Billing
Knowledge of ICD-10-CM and CPT
Knowledge of medical coding rules, regulations and compliance allowing to better handle issues such as medical necessity, claims denials, bundling issues and charge capture.
Knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes and identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.
Knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes, NCCI edits and LCDs.
Knowledge of how to integrate medical coding guidelines and payor specific coding requirements.
Responsible for being up to date and maintaining current status of coding credentials and completes annual continued education hours.
Observes work hours and provides proper notice regarding absences and tardiness, informs supervisor about own whereabouts throughout each workday.

Responsibilities

Applies expert knowledge of ICD‑10‑CM, CPT, and HCPCS coding to accurately code inpatient and outpatient encounters in compliance with AMA and CMS guidelines.
Reviews clinical documentation for medical necessity.
Resolves coding and billing issues.
Supports charge capture and denial prevention.
Collaborates with providers to ensure accurate, compliant reimbursement.
Performs coding and abstracting on all outpatient/inpatient procedures, evaluation and management encounter documentation and/or operative report by selecting and reporting ICD-10 diagnoses, CPT and HCPCS procedure codes and append modifiers when applicable.
Reviews and verifies office superbills and appropriate progress note and/or operative note.
Reports daily down coding and up coding documentation issues by practice and by physician to department Manager.
Reports any physician documentation issues to department manager.
Maintains positive working relationship with Physician Practices and communicates with office staff as needed.
Performs other related department duties which may be inclusive but not listed in job description.