Overview
The Certified Coder is responsible for ensuring that charges are assessed and entered in compliance with applicable coding regulations, standards, policies and guidelines as established by CMS and the various third party payers. This requires a thorough understanding of CCI edits and payer rules regarding medical necessity and bundling of services. The Coder is also responsible for assisting with provider inquiries regarding documentation standards as well as providing pertinent feedback to providers regarding the quality of clinical documentation. Coders may work remotely from home, which requires appropriate internet connectivity and physical space to complete work while maintaining HIPAA standards.
Qualifications
Education required: High School graduate or GED.
Education preferred: Formal coder training strongly preferred.
License, certification and/or registration: Certified Professional Coder or similar certifications (CCA, CPC, CCS, etc...)
Experience: Minimum of three years of medical coding experience required. Previous experience with electronic medical records and billing systems required. Previous experience in procedure coding preferred. Advanced education may be substituted for some experience.
Additional skills/abilities: Skill in using computer and calculator. Basic skills with excel spreadsheets. Knowledge of medical billing and patient accounting services. Knowledge of medical coding and clinic operating policies and procedures. Throrough knowledge of regulations, policies and procedures established by CMS and various third party payer related to coverage, medical necessity and bundling of services. Knowledge of the organization's policies and procedures. Ability to examine clinical documentation for accuracy and completeness. Ability to prepare records in accordance with detailed instructions. Ability to work effectively with co-workers and supervisors as a team member. Ability to communicate clearly. Upholds effective work habits including, but not limited to, regular attendance, teamwork, initiative, dependability and promptness. Thorough understanding of ICD-10 and CPT coding required.