JOB SUMMARY: The
primary purpose of this position is to review both procedural (CPT-4) and
diagnostic (ICD-10) coding to ensure healthcare services that are provided are
billed correctly and insurance regulations are adhered to. The position will be
staffed during clinic hours.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Have an in-depth understanding of coding and compliance
rules and regulations
2. Responsible for reviewing provider documentation, coding
and posting all charges for healthcare services; specialties include Primary
Care, OBGYN, General Surgery, Lab/Pathology and more
3. Review, code and post charges for hospital outpatient and
inpatient services
4. Work CCI/LMRP edits, claims manager rules and coding
related denials
5. Provide coding education (HCPCS, ICD-10 and CPT) to
providers and staff
6. Analyze reports to capture missing charges, reasons of
denials
7. Keep current knowledge of government and commercial
insurance changes for legislation regarding billing compliance issues
8. Assist patients and staff with coding and pricing issues
9. Participate in department meetings, educational seminars
and trainings
10. Perform other duties as assigned
SUPPLEMENTAL DUTIES AND RESPONSIBILITIES:
1. Maintain confidentiality
2. Maintain positive and respectful attitude while
supporting the clinic vision
3. Work effectively under pressure in a fast pace
environment
4. Remain flexible and adapt to changes in work priorities,
while adhering to policies and procedures
5. Work independently using good judgment and prioritization
skills
6. Attend relevant training sessions, department and
employee meetings
7. Abide by clinic protocols, ergonomic recommendations and
OSHA standards
8. Maintain a neat and well-groomed professional appearance
9. Assist and support team members with various duties; may
include research, data entry, scanning, mailing or faxing
WORKING CONDITIONS:
1. Is subject to interruptions, imposed deadlines and
frequent problem-solving activities
2. May be subject to hostile and emotionally upset patients,
staff, and personnel from other agencies.
3. Standard office environment and may have the ability to
work from home
PHYSICAL DEMANDS:
1. Abide by ergonomic recommendations of the position
2. Must possess sight/hearing senses, or use prosthetic
devices that will enable these senses to function adequately
3. Sit for several hours
4. Subject to lifting and carrying supplies averaging 25
lbs. (i.e. cartons of paper, medical supplies, office supplies, etc.)
5. Repetitive motions involving use of keyboard and phone