Healthcare Certified Coder is responsible for documentation review, coding, and data abstracting of medical service documentation to ensure Inform Diagnostics receives appropriate reimbursement and conforms to applicable guidelines and regulations. We make members/patients and their needs a primary focus; so developing and sustaining productive member relationships is key to success.
- Proficient, functional use of Current Procedural Terminology (CPT-4) and International Classification of Diseases (ICD-9) codes to ensure we maintain reliable communication with all physicians, insurance companies, and other healthcare providers across all disciplines.
- Researches and assigns pathology procedures (CPT-4) and diagnosis (ICD-9CM) codes based on review of the entire medical record.
- Analyzes and/or reviews detailed and highly complex code edits and transactions within Quadax/CRS System.
- Provides additional support to the billing staff by resolving complex cases and issues as assigned.
- Contributes to the development and maintenance of specialized educational materials.
- Maintains current knowledge of coding conventions, guidelines, updates, and regulations governing government and third party billing to ensure that coding and documentation meets regulatory guidelines and audit standards, and results in appropriate reimbursement.
- Meets and maintains department quality and production standards. Participates as needed in the testing and training of new system applications.
- Supports compliance and Code of Conduct by adhering to federal and state laws and regulations, accreditation, license requirements, and policies and procedures.
- Responds appropriately to observed fraud and abuse.
- Cross-training may occur as needed within various departments.
- High School diploma or equivalent required
- Minimum of 2 years coding experience, anatomic pathology preferred
- Working knowledge of CPT, HCPCS and ICD
- Certified Professional Coder Certification - CPC through AAPC
- Completion of a coding program.
- Demonstrated ability to understand the clinical content of a health record including research and analysis of complicated records.
- Demonstrated ability to abstract and assign all codes to pathology services performed.
- Ability to work in a fast-paced, deadline driven environment.
- Excellent written and oral communication.
Proficient in Microsoft Office Suite, specifically Word, Excel, and Outlook, and general working knowledge of Internet for business use.
This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.