Outpatient Coder

Conifer Health Solutions

About The Position

The Coder III is responsible for coordinating, performing, and completing Medicare compliancy. Coding consists of outpatient services in outpatient and inpatient services including procedures. To ensure coders provide technical aspects of the assignment, diagnostic and carried out in accordance with established standards and in compliance with NCQA and other regulatory agencies, and Tenet policy.

Requirements

AA Degree required
5 years coding experience required
Healthcare background is required
CPT current competence with ICD- 10, ICD-9, CPT-4, and HCPCS required
Coding scheme and reimbursement practices required
RHIA, RHIT, CCS, CPC or COC certification is required
Office, and Excel required

Nice To Haves

Bachelors Degree preferred
Willingness to be flexible and adaptable in a complex, matrix environment

Responsibilities

Performs all assigned billing in a timely manner
Communicates with the physician the documentation needed to complete job functions
Ensures accurate coding from the medical record regarding ICD-9 and ICD-10, appropriate evaluation and management CPT code
Updates patient record with patient’s current insurance, address and telephone numbers
Identifies primary care doctor and referral source with contact information and documents it in the medical record
Performs claims follow up and reviews with billing agent in a timely manner
Protects patient confidentiality according to HIPAA guidelines
Maintains proper credentials and researches coding issues to ensure correct coding initiative per CMS guidelines
Identifies and attends one course/conference per specialty, per year to continue education in the coding field
Must have Ortho billing experience