Certified Coder - In-House Position
Arbor Family Health
Innis, LA
This is NOT a Remote Position -
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.
Physical Requirements:
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 accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to walk, sit, talk and hear and be able to operate a personal computer, printer, telephone, calculator, and photocopier and fax machine. Must have excellent hearing and verbal skills to interact with the public. In addition, must have abilities to communicate in writing and orally. Fluency in written and spoken English is required.
Must have coordination of sight and body movements for various applications of procedures and dexterity of finger and wrist to operate basic word processing skills in the computer.
Exposure to various chemicals agents typically used in an office clinic setting
Walking, talking, hearing, reaching, bending, pulling, pushing, lifting & carrying (at least 20-50 lb. and push 5-20lbs) and travel in own vehicle for company business.
Ability to function effectively as a Team Member
OSHA: Category III: Job Classification includes those employees who perform jobs and tasks where NO CONTACT with blood borne pathogens occurs and Category I and Category II tasks ARE NOT a condition of employment.
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.
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.
Physical Requirements:
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 accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to walk, sit, talk and hear and be able to operate a personal computer, printer, telephone, calculator, and photocopier and fax machine. Must have excellent hearing and verbal skills to interact with the public. In addition, must have abilities to communicate in writing and orally. Fluency in written and spoken English is required.
Must have coordination of sight and body movements for various applications of procedures and dexterity of finger and wrist to operate basic word processing skills in the computer.
Exposure to various chemicals agents typically used in an office clinic setting
Walking, talking, hearing, reaching, bending, pulling, pushing, lifting & carrying (at least 20-50 lb. and push 5-20lbs) and travel in own vehicle for company business.
Ability to function effectively as a Team Member
OSHA: Category III: Job Classification includes those employees who perform jobs and tasks where NO CONTACT with blood borne pathogens occurs and Category I and Category II tasks ARE NOT a condition of employment.
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.