Certified Medical Coder - Onsite

Dallas Behavioral Healthcare Hospital•Desoto, TX

3d•Onsite

About The Position

The Medical Coder will be responsible for assigning procedure and diagnosis codes for insurance billing, reviewing claims data, and corresponding with insurance companies to ensure accurate reimbursement for healthcare claims. This role involves utilizing specialized software, ensuring compliance with legal and insurance rules, researching medical records, and resolving issues with denied claims. The position requires adherence to coding policies and industry-standard guidelines for CPT, ICD-9, and ICD-10, as well as answering coding questions and reviewing clinical documentation to ensure it meets coding standards.

Requirements

Certificate or associate's degree in medical coding/CPC.
A minimum of 1 year coding experience required preferably with psychiatric services.
Knowledge of medical terminology; basic and advanced ICD-9-CM coding; anatomy and physiology; computer data entry; and medical law, privacy and ethics.
Knowledge of CMS rules and regulations and current coding resources.
Knowledge of Healthcare Common Procedure Coding Systems (HCPCS), Current Procedural Terminology (CPT) coding and healthcare reimbursement methods.
Critical thinking skills and ability to resolve complex coding issues.
Knowledge of mathematical computations using addition, subtraction, multiplication, division, percentages in order to perform personnel/payroll assignment.
Ability to integrate multiple facts, statistics, and/or mathematical values when solving mathematical equations.
Ability to accurately enter data, prepare and maintain records, files, and reports.
Outstanding skills in giving attention to details with display of dexterity in maintaining confidentiality.
Must have advanced PC skills that include a combination of working in a Windows Operating System and Microsoft Outlook, Word and Excel as well as ability to use financial software and payroll systems (Kronos a plus).
Communicate effectively with a variety of individuals and function calmly in situations, which require a high degree of sensitivity, tact, and diplomacy.
Ability to exercise appropriate judgment in answering questions and releasing information; analyze and project consequences of decisions and/or recommendations.
Skill to research and analyze various personnel/payroll matters to recommend alternative actions and/or take an appropriate course of action.
Skill to independently interpret reference materials to comply with law, rules, regulations, policies, procedures, etc.
Ability to apply time management practices to prioritize, schedule and complete work effectively to comply with mandated policies and deadlines.
Ability to work on multiple tasks or parts of tasks simultaneously to ensure timely completion of work activities.
Must successfully pass background check, drug screen, physical and be able to provide positive employment references.

Nice To Haves

Certified Professional Coder (CPC)
CPC-Hospital
CPC-Payer
Certified Interventional Radiology Cardiovascular Coder (CIRCC)
Certified Professional Medical Auditor (CPMA)
Experience preferably with psychiatric services
Kronos a plus

Responsibilities

Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing.
Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission.
Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims.
Adhere to coding policies and procedures consistent with the industry-standard guidelines for CPT, ICD-9 and ICD-10.
Answer coding questions.
Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes.
Performs related duties, as requested.
Upholds the Organization's ethics and customer service standards.