Medical Coder

CHC•Everett, WA

About The Position

The Medical Coder is responsible for the day-to-day coding and billing operations for all services billable under grants, federal, state, and county programs including Medicare, Medicaid managed care and private insurances.

Requirements

Reads, speaks, understands and writes proficiently in English.
Effectively communicates orally and in writing.
Represents the organization in a professional and effective manner to the community.
Remains calm and effective in high pressure and emergency situations.
Works with initiative, energy and effectiveness in a fast-paced environment.
Produces work in high quantity and quality.
Problem-solves with creativity and ingenuity.
Knowledge of medical terminology.
Knowledge of HIPAA regulations and compliance.
Ability to make decisions regarding sensitive information.
Comprehensive knowledge and understanding of medical coding.
Proficiency in the use of Microsoft Office applications; Word, Excel and Outlook.
High School graduate or equivalent
Working in healthcare as a production coder (2 years)
Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Coding Specialist (CCS) certified by the American Health Information Management Association (AHIMA).

Nice To Haves

Bilingual skills.
Familiarity with Federally Qualified Health Centers.
Working in a not-for-profit organization.
Working with low income, multi-ethnic populations.
Working With Nextgen.

Responsibilities

Reviews and adjudicates coding of services from documentation in a timely manner.
Maintains physician/provider visit procedure codes and notes to identify appropriate ICD10 and CPT codes for charge processing.
Ensures that all diagnosis ICD10 codes, procedure CPT codes and HCPCS codes are identified, sequenced, and coded in an accurate and ethical manner for optimized reimbursement.
Assigns Evaluation and Management codes and key concepts/elements documented in the patient notes, utilizing defined coding guidelines applicable to professional and technical standards.
Researches and identifies correct codes for routine, and/or new or unusual diagnosis and procedures not clearly listed in ICD10 and CPT guidelines and functions of the position.
Identifies all procedures that may require modifiers (including 340B) for billing and reporting.
Consults with providers for clarification of clinical data when encountering conflicting or ambiguous information and/or significant missing documentation.
Tracks cases with insufficient documentation, ensuring the case is appropriately coded and billed.
Ensures documentation adheres to federal, state and county billing policies.
Adheres to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care.