Coder-Health Information-8125

Kingman Healthcare•Kingman, AZ

About The Position

The Professional Services Coder and Coding Reviewer evaluates medical record documentation and charge reports for completeness, accuracy, and compliance with Correct Coding Initiative edits. The role codes professional charges and performs coding reviews and/or surgical coding for practices and providers to support accurate, timely billing and data quality in accordance with state, federal, and regulatory requirements. It also evaluates insurance requests and claim denials to assist the Business Office with the revenue cycle. The position provides technical guidance, training, and ongoing coding education to physicians, office staff, and other ancillary departments when instructed. It manages work activities, assignments, and schedules to support timely information submission, and provides reports on collected, abstracted, and coded data as requested. The coder stays current on coding and documentation laws, regulations, trends, and issues through professional publications and workshops. The role also requires dependability, teamwork, patient confidentiality, productive working relationships, attendance at required departmental meetings, maintenance of certification, and continuing education. Other duties and assignments may be directed or requested.

Requirements

High school diploma or equivalent.
Advanced knowledge of ICD-10-CM, CPT, HCPCS, medical terminology, and medically approved abbreviations.
Thorough understanding of CMS coding and billing guidelines.
Excellent written and verbal communication skills and critical-thinking skills.
Ability to work independently and make decisions based on specialized knowledge.
Computer literacy and familiarity with basic office equipment.
Maintain a current Certified Coding Specialist (CCS) certification from AHIMA or Certified Professional Coder (CPC) certification from AAPC, or be enrolled with AHIMA or AAPC and actively working toward one of these certifications; certification is required within 12 months of hire or placement.
Ability to collaborate with individual practices, the Business Office, and Operations Directors.
Ability to stand and walk while performing job responsibilities, work at a computer for extended periods, and perform some bending and lifting.
Travel to off-site locations as required.
Possible, but not routine, potential for exposure to blood, body fluids, or tissues (Category II).

Nice To Haves

Experience in a medical billing or coding office.

Responsibilities

Evaluate medical record documentation and charge reports for completeness, accuracy, and compliance with Correct Coding Initiative edits.
Evaluate and report audit findings, or review and report results to physicians and/or operations directors.
Evaluate insurance requests and claim denials to assist the Business Office with the revenue cycle.
Ensure data quality in compliance with state, federal, and regulatory requirements.
Code professional charges to support accurate and timely billing.
Perform coding reviews and/or surgical coding for practices and providers.
Provide technical guidance, training, and ongoing coding education to physicians, office staff, and ancillary departments when instructed.
Manage work activities, assignments, and schedules to ensure accurate and timely submission of information.
Provide reports as requested on data collected, abstracted, and coded.
Review bulletins, newsletters, and periodicals and attend workshops to remain current on medical record coding and documentation laws, regulations, issues, and trends.
Maintain patient confidentiality and demonstrate dependability and teamwork.
Develop and maintain effective relationships with providers, provider staff, operational directors, and Business Office staff.
Attend departmental meetings as required, maintain certification, and obtain continuing education units.
Complete other duties, projects, and assignments as directed or requested.