HIM Medical Records Certified Medical Coder

Georgetown Behavioral Health Institute•Georgetown, TX

About The Position

The Medical Coder complies with legal requirements and industry standards for coding procedures and practices. The role audits and reviews coding to ensure documentation is accurate, assigns and sequences codes for services rendered, and works with the business office to help ensure bills are satisfied in a timely manner. The Medical Coder also communicates with insurance companies about coding issues, provides statistical data for other departments’ analysis and research, and contacts physicians and other healthcare professionals with coding questions. The position requires reviewing clinical documentation and claims, researching medical records, resolving denied-claim issues, and maintaining accurate records. The employee upholds the organization’s ethics and customer service standards and performs related duties as requested.

Requirements

High school degree required.
At least one year of coding experience required, preferably with psychiatric services.
Must possess or obtain a valid CPR certification and certification in facility-approved verbal de-escalation and physical crisis management techniques within 30 days of hire and before completing orientation.
Knowledge of medical terminology, 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 HCPCS, CPT coding, and healthcare reimbursement methods.
Critical-thinking skills and ability to resolve complex coding issues.
Ability to perform mathematical computations and integrate multiple facts, statistics, or values when solving equations.
Ability to accurately enter data and prepare and maintain records, files, and reports.
Attention to detail and ability to maintain confidentiality.
Advanced PC skills, including Windows, Microsoft Outlook, Word, and Excel; ability to use financial software and payroll systems.
Ability to communicate effectively and remain calm in sensitive situations requiring tact and diplomacy.
Ability to exercise sound judgment when answering questions or releasing information and to analyze likely consequences of decisions or recommendations.
Ability to research and analyze personnel/payroll matters and recommend or take appropriate action.
Ability to interpret reference materials independently and comply with laws, rules, regulations, policies, and procedures.
Ability to prioritize, schedule, and complete work effectively within mandated policies and deadlines.
Ability to work on multiple tasks simultaneously and complete work activities on time.
Ability to perform the listed physical activities and meet the stated hearing, visual, lifting, and work-environment requirements, with or without reasonable accommodations.

Nice To Haves

Certificate or associate’s degree in medical coding.
Certified Professional Coder (CPC), CPC-Hospital, CPC-Payer, Certified Interventional Radiology Cardiovascular Coder (CIRCC), or Certified Professional Medical Auditor (CPMA) certification.
Bilingual English/Spanish.
Familiarity with Kronos.

Responsibilities

Use specialized medical classification software to assign procedure and diagnosis codes for insurance billing.
Review claims data to verify codes meet legal and insurance requirements and that required signatures and authorizations are in place before submission.
Research medical records and correspond with insurance companies and healthcare professionals to resolve issues arising from denied claims.
Follow coding policies and procedures consistent with industry-standard CPT, ICD-9, and ICD-10 guidelines.
Answer coding questions.
Review clinical documentation to ensure it supports the level of CPT and ICD-10 codes assigned.
Assign and sequence codes for services rendered and collaborate with the business office to help ensure bills are satisfied in a timely manner.
Communicate with insurance companies about coding issues and provide statistical data for analysis and research by other departments.
Contact physicians and other healthcare professionals with coding questions.
Uphold the organization’s ethics and customer service standards, and perform related duties as requested.