Role and Responsibilities The Certified Coding Specialist is responsible for assigned work queue’s for physician services via medical records (encounter) for office visits, outpatient surgery, office procedures and hospital visits utilizing ICD-10-CM and CPT-4 codes. This requires thorough review of the medical record to validate assigned codes for optimal reimbursement. Research coding and regulatory guidelines that impact coding and billing for services to obtain relevant and timely information for internal utilization utilizing ICD-10-CM and HCPCS/CPT-4 codes. Ensures appropriate charge capture. Essential Functions: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Employees must perform all duties and responsibilities in accordance with the AAPC/AHIMA Standards of Ethical Coding and Company’s code of Ethics and Business Conduct.
- Collects and analyzes outpatient clinical information to accurately report codes and abstract relevant information used for reimbursement.
- Demonstrates a high degree of independence in performance of responsibilities, working effectively with the department team members and management.
- Exhibits strong time management, problem solving and communication skills.
- Is able to effectively utilize various computer systems in performance of job functions.
- Demonstrates an understanding of the billing cycle. Prioritizes data in accordance with established guidelines of all governmental regulatory agencies and third party payers.
- Demonstrates competency in coding and abstracting outpatient records in accordance with ICD-10-CM/PCS and CPT-4 coding conventions and national coding guidelines.
- Participates in continuing education opportunities and shows initiative in researching difficult or interesting subjects. Shares the information with the rest of the team.
- Understands coding conventions/rules as published in the "Coding Clinic" and "CPT Assistant", as well as changes in medical terminology and advances in medical and surgical procedures.
Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Physical Demands: While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. The employee may occasionally lift up to 25 pounds. Qualifications and Education Requirements - Education: High School Diploma, some college preferred
- License/Certifications: Certified Professional Coder Certification (CPC) required
- Experience: Must have at least 1 year of directly related experience
- Preferred: Clinical background or auditing experience
- Knowledge or use of an EHR or EPIC experience is a plus
- Detail-oriented, dependable and trustworthy, with a positive attitude
- Ability to meet expected monthly quality and productivity standards according to departmental policy
- Ability to adapt to and deal with change and company growth process
- Ability to organize, prioritize, work to meet deadlines
- Ability to utilize the ICD-10-CM/PCS and CPT -4 coding convention to code medical record entries; abstract information from medical records; read medical record notes and reports
- Ability to work effectively with individuals at all levels of the organization
- Ability to communicate effectively
- Ability and willingness to work overtime when needed
Salary: $30.00/hour Competencies - Teamwork Orientation.
- Ethical Conduct.
- Communication Proficiency.
- Organizational Skills.
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