BMS CODER

Job Summary

The Coder is responsible to review, abstract and assign appropriate CPT/HCPC and ICD 10 codes to all BMS clinic visits as well as services provided by BMS providers in the hospital setting.  The Coder is also responsible to assist the Revenue Cycle team.  Under the direction of the System Director of Revenue Cycle, the Coder collaborates with the Providers, BMS Practice Managers, and COO to ensure timely and compliant billing for services provided.

Job Requirements

1. Minimum Education Requirement

Training/certification from an accredited coding/billing program.  Must be certified upon hire, or successfully complete certification exam within 3 months of hire.

1. Minimum Experience Requirement
   1. Three years’ experience in medical office billing preferred.
   2. Working knowledge of computers, billing and basic office software, especially Excel.
   3. Ability to communicate with all levels of staff.
   4. Analytical ability to detect trends in reimbursement/collections and to recommend or take corrective action.
      1. Prior experience using encoder software.

Demands are typical of a position in a medical billing office, with extensive periods of sitting at a desk working on a computer. External applicants, as well as position incumbents who become disabled, must be able to perform the essential functions, either unaided or with the assistance of a reasonable accommodation, to be determined on a case-by-case basis.

Required Skills 

Because medical billing duties are so varied, a flexible skill set is needed to perform them well.   The following skills and personality traits are necessary to succeed in the field of medical billing/collections.

• Ability to multi-task
• Ability to understand insurance denials and payer remittances
• Ability to understand different insurance policies/coverages
• Ability to employ people skills to handle different personalities and situations

Essential Functions 

Coder responsibilities below are subject to change as the job demands change:

• Using encoder software to compliantly apply appropriate CPT/HCPC and ICD codes to claims.
• Use claims submission software to review and resolve any rejected/denied or otherwise unpaid claims.
• Promptly reports any trends or issues impacting timely coding and billing of claims to management team.  Collaborates with team, including providers, practice managers and revenue cycle to resolve.
• Act as a consultant for billing/coding questions from BMS practice staff.
• Maintain coding credential and staying up to date on changing guidelines by obtaining an appropriate number of CEUs
• Researching unpaid claims.  Submitting appeals as necessary.
• Researching and resolving credit balances.

Employee Statement of Understanding

I understand that this document is intended to describe the general nature and level of work being performed. The statements in this document are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.