About The Position

The Coder I is responsible for abstraction and assigning valid CPT, ICD-10, HCPCs codes and modifiers to ensure appropriate reimbursement in accordance with federal state, and private health plans as well as organization and regulatory guidance. This role is typically responsible for less complex coding with oversight.

Requirements

  • High school diploma or GED/equivalent (required)
  • Certified Professional Coder (CPC) accredited by the American Academy of Professional Coders (AAPC) (required)
  • Certified Coding Specialist (CCS), Certified Coding Specialist Physician Based (CCS-P) or Certified Coding Assistant (CCA) accredited by the American Health Information Management Association (AHIMA) (required)
  • Understands and applies regulatory changes and stays current with coding updates, including NCCI and MUE edits
  • Working knowledge of concepts, practices, policies, procedures, standards, systems, and tools applicable to medical records coding, including documentation requirements and medical terminology
  • Displays a strong work ethic with demonstrated ability to work, both independently and collaboratively as part of a team, with multiple providers and deadline constraints
  • Must be able to communicate effectively, demonstration a high level of professionalism in all communications
  • Proper grammar, spelling, punctuation, and composition expected in correspondence and report preparation
  • Ability to solve practical problems and deal with a variety of concrete variable in situations where only limited standardization exists
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or scheduled form
  • Must be proficient with Microsoft Office, Google Chrome, Internet Navigation, and database management

Nice To Haves

  • One to four (1-4) years physician coding experience (preferred)

Responsibilities

  • Accurately abstracts information from the service documentation, assigns and sequences appropriate CPT, ICD-10, and HCPCs codes into the appropriate billing systems, ensuring compliance with established guidelines
  • Reviews and resolves coding denials
  • Completes charges sessions in the assigned work queues in a timely manner
  • Completes documentation meeting the current EM Guidelines for providers
  • Ensures documentation meets the Teaching Physician Rules as mandated by CMS and ULH Policies prior to release of a code for billing
  • Ensures documentation for Advanced Practice Providers meets the payer-specific rules prior to release of a code for billing
  • Provides comments/suggestion relative to weak areas identified in the coding reviews
  • Provides trending deficiencies to Senior Manager and Compliance Educator, as appropriate
  • Meets or exceeds organizational coding production and quality standards
  • Participates in special projects and completes other duties as assigned
  • Maintains daily/weekly communication with office managers, department, and providers.
  • Ability to work within a team environment and meet monthly goals
  • Maintain compliance with rules and regulations regarding coding
  • Responds in a timely manner to questions from manager, providers, department, and representatives
  • Maintains compliance with all company policies, procedures and standards of conduct
  • Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
  • Performs other duties as assigned
  • Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
  • Maintains confidentiality and protects sensitive data at all times
  • Adheres to organizational and department specific safety standards and guidelines
  • Works collaboratively and supports efforts of team members
  • Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

High school or GED

Number of Employees

501-1,000 employees

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