Certified Coder - Corporate Office

LOCATION: Central Billing - Corporate Office

ADDRESS: 200 Gold Circle, Suite 120 Dakota Dunes, SD 57049

CLASSIFICATION: Non-Exempt Full-Time

REPORTS TO: Central Billing Manager

SUMMARY/OBJECTIVE:

Coding medical documentation for insurance claims.

ESSENTIAL JOB DUTIES: (This list may not include all of the duties assigned.)

1. Assign codes to procedures and diagnoses using CPT (Current Procedural Terminology) codes, HCPCS (Healthcare Common Procedure Coding System) codes, and ICD (International Classification of Diseases) codes. Knowledge of HCC (Hierarchical Condition Category) coding.
2. Ensure codes are current, assigned accurately and sequenced correctly in each instance, in accordance with government and insurance regulations, with a high level of accuracy.
3. Keep up to date on various payer guidelines and new coding changes or opportunities.
4. Follow-up with the provider on any documentation that is insufficient or unclear. Communicate with other clinical staff regarding documentation when needed. Search for information where the coding is complex or unusual.
5. Conduct chart audits to ensure all documentation is accurate, precise, and complete, providing feedback/education to providers when necessary.
6. Monitor and reconcile outstanding voucher report for missed charges.
7. Allocate payments in the system and complete processes as directed.
8. Prepare quarterly coding graphs.
9. Collaborate with billing department to ensure all claims are satisfied in a timely manner.
10. Performs related work as required.

COMPETENCIES:

1. Problem Solving/Analysis
2. Time Management
3. Communication Proficiency
4. Teamwork Orientation

EDUCATION AND EXPERIENCE:

Required:

1. High School graduation or GED.
2. Strong knowledge of anatomy, physiology and medical terminology
3. Commitment to a high level of customer service
4. Solid oral and written communication skills
5. Excellent typing and 10-key speed and accuracy
6. Able to work independently but embrace teamwork and flexibility

Preferred:

1. Minimum two year medical coding experience

2. Motivated, detail oriented and outstanding people skills

CERTIFICATE/LICENSE: Certified Professional Coder (CPC) certification

Job description is available upon request.