Certified Coder/Biller - In-House Position
Arbor Family Health
Innis, LA
This is an In-House Potition
JOB SUMMARY:
Abstracts clinical information from medical records and assigns the appropriate ICD or CPT codes using industry-standard coding guidelines. Assigns required DRG (diagnosis-related grouping) codes. Works with coding databases and software to input and maintain data according to standard procedures. Performs quality audits of work. Maintains and up-to-date knowledge of coding and documentation requirements. Reports to the Medical Records Coding Supervisor.
Job Specifications:
Duties & Responsibilities: Specific to Department:
· Assigning Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases Tenth Revision Clinical Modification (ICD-10 CM).
· Assigns Ambulatory Payment Classifications (APC) or Diagnosis related groups (DRG) codes.
· Makes decisions on which codes and functions should be assigned in each instance, including diagnostic and procedural information, significant reportable elements and significant reportable elements and other complex classifications.
· Account for coding and abstracting of patient encounters
· Research and analyze data needs for reimbursement
· Make sure that codes are sequenced according to government and insurance regulations
· Ensure all medical records are filed and processed correctly
· Analyze medical records and identify documentation deficiencies
· Serve as resource and subject matter expert to other coding staff.
· Review and verify documentation for diagnoses, procedures and treatment results
· Identify diagnostic and procedural information
· Processes claims through charge entry process for medical and dental clinics.
· Performs office coding ICD-10 for all super-bills.
· Follows up on all types of issues associated with denials of claims
· Performs claims clean up functions in billing department to include working denials, guarantor’s verifications and follow up on missing information needed for billing process as well as any other issues as directed by the Reimbursement Coordinator.
· Keeps tracking logs of all worked claims for cleanup action.
· Reviews details of daily super bills including posting of charges, coding, primary diagnosis designation, verification of insurance and patient information documentation as needed.
· Records diagnosis on specified forms for use in compiling clinic insurance forms.
· Follow up on secondary payment on Medicare claims
General Performance Standards:
Utilizes clinic resources efficiently and effectively.
Possess a sense of discipline to work in accordance with accepted office standards.
Develops a performance level whereby minimal supervision is needed and seeks assistance when issues arise beyond current knowledge or experience.
Attends clinic meetings and staff meetings and participates actively in problem- solving, staff meeting discussions and in-services.
Communicates clearly and effectively with patients, visitors and team members and adheres to the customer service standards as outlined by the Clinic.
Respects the confidentiality of patient information and clinic business and supports the clinic mission and patient rights and responsibilities.
Performs job responsibilities in accordance with all clinic policies and procedures.
Participates in education opportunities as appropriate which will increase one’s ability to perform the job responsibilities effectively.
Remains flexible to be cross trained in other job responsibilities as identified and can be depended upon to modify work schedule as required by the clinic and according to policy.
Keeps current on and adheres to all policies and procedures as enumerated in the Policy & Procedure Manual.
JOB SUMMARY:
Abstracts clinical information from medical records and assigns the appropriate ICD or CPT codes using industry-standard coding guidelines. Assigns required DRG (diagnosis-related grouping) codes. Works with coding databases and software to input and maintain data according to standard procedures. Performs quality audits of work. Maintains and up-to-date knowledge of coding and documentation requirements. Reports to the Medical Records Coding Supervisor.
Job Specifications:
Duties & Responsibilities: Specific to Department:
· Assigning Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases Tenth Revision Clinical Modification (ICD-10 CM).
· Assigns Ambulatory Payment Classifications (APC) or Diagnosis related groups (DRG) codes.
· Makes decisions on which codes and functions should be assigned in each instance, including diagnostic and procedural information, significant reportable elements and significant reportable elements and other complex classifications.
· Account for coding and abstracting of patient encounters
· Research and analyze data needs for reimbursement
· Make sure that codes are sequenced according to government and insurance regulations
· Ensure all medical records are filed and processed correctly
· Analyze medical records and identify documentation deficiencies
· Serve as resource and subject matter expert to other coding staff.
· Review and verify documentation for diagnoses, procedures and treatment results
· Identify diagnostic and procedural information
· Processes claims through charge entry process for medical and dental clinics.
· Performs office coding ICD-10 for all super-bills.
· Follows up on all types of issues associated with denials of claims
· Performs claims clean up functions in billing department to include working denials, guarantor’s verifications and follow up on missing information needed for billing process as well as any other issues as directed by the Reimbursement Coordinator.
· Keeps tracking logs of all worked claims for cleanup action.
· Reviews details of daily super bills including posting of charges, coding, primary diagnosis designation, verification of insurance and patient information documentation as needed.
· Records diagnosis on specified forms for use in compiling clinic insurance forms.
· Follow up on secondary payment on Medicare claims
General Performance Standards:
Utilizes clinic resources efficiently and effectively.
Possess a sense of discipline to work in accordance with accepted office standards.
Develops a performance level whereby minimal supervision is needed and seeks assistance when issues arise beyond current knowledge or experience.
Attends clinic meetings and staff meetings and participates actively in problem- solving, staff meeting discussions and in-services.
Communicates clearly and effectively with patients, visitors and team members and adheres to the customer service standards as outlined by the Clinic.
Respects the confidentiality of patient information and clinic business and supports the clinic mission and patient rights and responsibilities.
Performs job responsibilities in accordance with all clinic policies and procedures.
Participates in education opportunities as appropriate which will increase one’s ability to perform the job responsibilities effectively.
Remains flexible to be cross trained in other job responsibilities as identified and can be depended upon to modify work schedule as required by the clinic and according to policy.
Keeps current on and adheres to all policies and procedures as enumerated in the Policy & Procedure Manual.