Coder, Certified

Shenandoah Medical Center•Shenandoah, IA

About The Position

The Certified Coder reviews clinical documentation, assigns and sequences diagnosis and procedure codes, and abstracts accurate clinical information to support appropriate billing and reimbursement. The role uses multiple information systems to select patient accounts and enter billable charges, participates in audits, and works with staff, providers, departments, compliance, and coding colleagues to resolve documentation and billing issues. The position maintains coding knowledge and professional standards through continuing education and ongoing awareness of regulatory requirements and changes to coding systems. It organizes data to identify documentation trends and provides feedback and education to staff and healthcare providers. The role also follows organizational policies, procedures, and regulatory requirements; participates in safety and quality activities; and performs other duties as assigned.

Requirements

Hold a CPC, COC, CCS, or CCS-P certification and meet its continuing education requirements.
Maintain current coding knowledge, including NCCI standards and changes in ICD-10-CM/PCS, CPT-4, and HCPCS.
Demonstrate organizational skills, self-motivation, and flexibility.

Responsibilities

Review documentation to determine diagnoses and procedures performed.
Assign charge master codes and modifiers for appropriate billing and sequencing.
Use information systems to select the correct patient account and enter billable charges.
Participate in audits to identify lost charges and assess billing and coding accuracy.
Contact staff and providers regarding missing or inaccurate documentation.
Work with departments to resolve billing issues.
Collaborate with healthcare providers, compliance, and coding teams to identify documentation changes that may maximize reimbursement.
Plan and implement continuing education to meet certification requirements for CPC, COC, CCS, or CCS-P.
Maintain current knowledge of national NCCI coding standards and applicable JCAHO/CMS criteria for coding and billing.
Maintain knowledge of changes in ICD-10-CM/PCS, CPT-4, and HCPCS, and provide feedback and education on codes that have changed or are no longer appropriate for billable items.
Organize data to identify documentation trends and provide feedback to staff and healthcare providers to improve capture of billable items.
Comply with departmental and organizational policies, procedures, and regulatory requirements, including OSHA, CMS, and Joint Commission requirements.
Participate in corporate and departmental safety and quality activities.
Perform other duties as assigned.