CERTIFIED MEDICAL CODER

PSN Services LLC•Plano, TX

About The Position

The Certified Medical Coder is responsible for translating healthcare providers’ diagnostic and procedural phrases into coded form. The Certified Medical Coder reviews and analyzes health records daily to ensure correct coding.

Requirements

High School Diploma or GED required.
Certified Professional Coding (CPC) certification preferred or equivalent.
2-3 years of experience in ASC coding and insurance billing required.
Knowledge of the ICD-10, ICD-9, and CPT-/HCPCS universal coding systems.
Knowledge of coding and clinic operating policies.
Knowledge of insurance carrier coding requirements to ensure proper coding based on License and specialty.
Strong computer skills in MS Office/Windows (Word and Excel required).
Knowledge of Medical terminology.
Knowledge of third-party billing procedures across a variety of payer systems.
Knowledge of billing and financial concepts.

Nice To Haves

Certified Professional Coding (CPC) certification preferred or equivalent.

Responsibilities

Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT code.
Assists billing staff establish the medical necessity of charges.
Provides feedback to the clinical staff on coding issues and reviewing denials.
Provides training to each provider regarding errors identified and corrected.
Obtains necessary clarification of information on the notes and charts.
Provides weekly trending reports by provider to COO or designated administrator: regarding coding errors, coding changes, missing information from charts, etc.
Monitors and audits proper diagnosis code with appropriate CPT code for billing purposes.
Ensures that all medical records have been signed by the appropriate parties.
Evaluates medical records for documentation consistency and adequacy.
Reviews appropriate medical codes to all diagnoses or services.
Enters and organizes the codes into management software.
Reviews records for compliance with established third-party reimbursement agencies and special screening criteria.
Assists providers with coding procedures to ensure correct billing.
Participates with other staff to follow up on accounts until no balance or turned over for collection. Completes coding projects as needed.
Attends various meetings and professional development programs as required.
Manages billing as needed.
All other duties as assigned