Coder I

Saginaw Valley State University-posted 3 months ago

Full-time • Mid Level

Midland, MI

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This position is responsible for coding all services including major and minor surgical cases performed in both the office and hospital setting for MyMichigan Medical Group, Family Practice Center and the MyMichigan Urgent Care locations. This position monitors compliance with third party payers guidelines while ensuring the maximum allowed reimbursement is attained. This position requires broad knowledge of current payer rules for all insurance companies we participate with, in addition to analytical skills to ensure all procedures are coded correctly for a timely and accurate reimbursement from all payers. This position must be able to work independently and make decisions based on their broad knowledge of current procedure terminology (CPT) and International Classification of Diseases (ICD) coding rules and regulations.

Codes visits and services performed in both the office and hospital setting within 48 hours of receipt.
Uses the Epic coding edits, CPT Assistant, and Centers for Medicare and Medicaid Services (CMS) coding guidelines to make necessary corrections to ICD, CPT, Healthcare Common Procedure Coding Systems (HCPCS), codes, modifiers and place of service to ensure clean claims.
Codes all major and minor surgical cases, including obstetrics, performed in both the office and hospital setting, within 48 hours of receipt.
Utilizes clinical knowledge to interact with physicians/provider on a regular basis to assist in improving documentation.
Demonstrates willingness to participate in continuing education to enhance coding knowledge.
Reviews accounts related to patient or payer complaints/concerns. After review, responsible for timely communication to the patient, payer and physician (if needed) to address their concern.
Meets established productivity guidelines.
Other duties as assigned.

Two (2) years physician coding and billing experience and four (4) years’ experience in the medical field is preferred.
One (1) year with direct physician contact is preferred.
Knowledge of medical terminology and anatomy.
Proficiency in the use of personal computer.
Knowledge of medical record/patient confidentiality laws.
Great organizational skills are required.
Oral, written and interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to communicate ideas and concepts in a clear and understandable manner.

Associate degree in Health Information Technology Program accredited by Commission on Accreditation for Health Informatics and Information Management (CAHIM).
Coding experience from an American Health Information Management Association (AHIMA) approved internship is preferred.

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