Certified Coder (PRN) - Remote

Job Details

Description

General Summary

Under the direction of the Revenue Cycle Manager, performs various duties to accurately interpret and bill physician charges for physician services, enters charges into the Billing System using appropriate CPT and ICD-10 codes.

Essential Functions

1. Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.

2. Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.

3. Enters appropriate data into the Billing System by selecting the appropriate codes, diagnosis, modifiers, and times of start and stop of the case, Anesthesiologist, CRNA, and surgeon information to complete the charge process.

4. Contacts physicians through management regarding procedures and other services billed to ensure proper coding.

5. Responsible for reviewing patient logs and other reports of clinical activity to ensure billing is captured for all patients.

6. Monitors and follows up to ensure all services that can be billed are captured and coded for billing.

7. Responsible for ensuring the batch processes for all coded charges.

8. Utilizes batch-logging systems to comply with internal audit standards.

9. Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.

10. Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for physicians' services.

11. Works in coordination with other members of the Physicians' Billing Office as necessary.

12. Meets and exceeds short and long-term goals as established for the department.

13. Perform duties and job functions in accordance with the policies and procedures established for the department.

14. Corrects coding denial errors and resubmits claim for reimbursement.

15. Reports to work, meetings, and professional obligations on time.

16. Participates in administrative staff meetings and attends other meetings and seminars.

17. Assists in evaluation of reports, decisions, and results of department in relation to established goals.

18. Recommends new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed.

19. Serves as a member of the Billing Department. Performs duties necessary to ensure the team's projects/goals are completed.

20. Takes ownership of special projects, reviews data and follows through with detailed action plans.

21. Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.

22. Participates in corporate, departmental, and team meetings as necessary, providing input as necessary.

23. Maintain active certification requirements and submits CEUs for review.

24. Performs other related duties as required.

Supervisory Requirements

This position will not supervise any other staff members.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear. The employee must occasionally lift and/or move more than 25 pounds.

Qualifications

Minimum Qualifications

1. Must be a Certified Professional Coder (CPC) with experience in CPT and ICD-10 coding.

2. Must demonstrate a good working knowledge of medical terminology, including anatomy.

3. Must have knowledge of current third-party billing and collection regulatory guidelines.

4. Must show the ability to have excellent interpersonal skills and communication to interact with all walks of life, internal and external to UCA, from all educational or cultural backgrounds.

5. Must show the ability to work independently or within a team in a fast-paced environment.

6. Must show proficiency in use of a variety of office equipment including a PC, Windows, MSOffice, EMR system, multi-line telephone, copier, facsimile machine, etc.

7. Must show the ability to maintain confidentiality, including strict adherence to HIPAA and UCA Guidelines.

8. Must have a high school diploma or GED equivalent.

Preferred Qualifications

1. CPC coder with at least two years’ experience in CPT and ICD-10 coding in a physician office setting.

2. Experience working in Veradigm PM/EHR (formerly Allscripts).

Licensure, Certification, Registration Requirements

Certified Professional Coder – CPC