Description

POSITION SUMMARY:

This is a mid-level, work from work position. Coder is responsible for:

• Analyzing provider documentation
• Assign and sequence ICD-10-CM, CPT®/HCPCS appropriately
• Append billing modifiers when appropriate
• Reconcile CPT(s)
• Resolves billing edits according to 3M Code editor
• Participates in educational activities and attends staff meetings.

POSITION EDUCATION/ QUALIFICATIONS­:

• Coding credential from an accredited coding organization required
• Credentials from AHIMA, AAPC preferred
• Extensive knowledge of medical terminology
• Knowledge of Coding Guidelines
• Knowledge of CPT rules and regulations
• Knowledge of NCCI policies
• Highly reliable

• Must be a team player with good people skills and possess strong initiative to get daily work finished and processed

• Maintain productivity levels

JOB KNOWLEDGE/EXPERIENCE­:

• Extensive experience in medical coding, medical terminology, and anatomy and physiology required; 3 year of coding experience preferred
• Requires reasoning ability and good independent judgment
• Ability to perform productive research quickly
• Requires working with minimal interruptions
• Must have an understanding of laws and ethics related to health insurance, medical billing and Health insurance Portability and Accountability Act (HIPPA)
• Computer and coding software experience required, 3M encoder preferred
• Advanced computer skills required with knowledge of Microsoft Office suite
• Experience in Professional coding and billing a plus

POSITION RESPONSIBILITES:

• Promotes the facility mission, vision and values by effectively communicating them to others.  Considers mission, vision and values in developing services, standards and practices
• Coding ICD-10-CM to the highest level of specificity
• Accurately Codes outpatient procedures according to CPT guidelines
• Must be able to validate CPT based on medical record documentation
• Ability to code outpatient record types such as: Ambulatory surgery, General surgery, ENT surgery, Eye/Vision surgery, Interventional Radiology, Orthopedic surgery, Cardiovascular surgery, Spinal surgery, Pediatric surgery, Stereotactic surgery, Reconstruction/Plastic, Ob/Gyn surgery, Dental surgery, ER, Observations, Radiation/Chemo Oncology, Infusions, ect…
• Queries physicians for clarification when ambiguous, vague, or incomplete information is identified
• Ability to accurately attach HCPCS Level I and Level II modifiers for billing purposes                     
• Utilizes computerized 3M Coding Software
• Utilizes and researches 3M Coding references for final coding
• Must be able to identify medical abbreviations, terms and their meanings
• Codes all available records in a timely a manner
• Must be able to multitask        
• Meets quality standards of having ≥ 95% of charts coded accurately                         
• Meets productivity standards set forth by the coding manager                                    
• Communicates with Coding Manager to solve problems and to clarify coding issues
• Assign mnemonics to unbilled accounts as appropriate
• Maintains a good working relationship within the department, other departments, and medical staff
• Assist the business office with clearing reimbursement and denial issues
• Clears AEOS in a timely manner
• Communicates via email and/or phone with other departments to obtain pertinent information in order to code the account
• Willing to transition into Inpatient coding

• Coding of introductory level Inpatient accounts may be required
• Communicates with RMF clinic management to ensure timely professional billing
• Ability to identify and accurately assign discharge/disposition status
• Must take initiative to further coding knowledge
• Attends workshops, seminars or conferences that pertain to position and that fulfill CE hour requirements
• References ICD-10-CM, CPT, and HCPCS Level II code books as needed                
• Reviews Coding Clinic updates and continuing education periodicals in a timely manner
• Adheres to the Health Information Management Policies and Procedures for Coding            
• Adheres to the Coding Compliance Plan                                                                     
• Follows the AHIMA Standards of Ethical Coding                                                                           
• Maintains confidentiality and safeguards all patient related information.                   
• Performs other duties as assigned       

LINES OF REPSONSIBILITES:

(Chain-of-command)