Certified Medical Coder Job in Albuquerque, New Mexico

Certified Coder: On-site

POSITION SUMMARY:

The Certified Coder performs audits of documentation, billing, and coding in accordance with all applicable State and Federal laws and company compliance standards. The Certified Coder performs written reports of the audit findings and develops and provides educational programs for the physicians and staff on coding and reimbursement issues. This position ensures and performs duties that help the organization achieve its mission, vision while demonstrating and adhering to the core values.

ESSENTIAL FUNCTIONS:

Reasonable Accommodations Statement:

To perform this job successfully, an individual must be able to perform the essential duties satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s):

• Plans, performs, and documents all Coding Compliance audits as scheduled in the annual plan and/or as needed per management request or if there is a known change in risk.
• Monitors coding and documentation accuracy by performing regular audits of potential areas of risk.
• Ensures compliance with Federal and State laws and regulations.
• Performs RAC risk assessment audits and monitor RAC websites for current activity and findings of ongoing RAC audits.
• Maintains entering of appropriate charges daily as it relates to hospital visits, infusion and radiology services.
• Maintains ongoing training for the Physicians regarding feedback for documentation of office visits and any other trends.
• Performs follow up reviews with physicians and staff regarding implementation of accepted recommendations.
• Provides input into the development of the annual audit plan, specifically in regards to billing and coding compliance issues.
• Serves as a resource to the practice to furnish and obtains information on accurate and ethical coding as well as documentation standards, guidelines, and regulatory requirements.
• Maintains knowledge of current coding and regulatory issues as they relate to the practice specialty.
• Provides coding guidance to the other areas of the billing department including but not limited to Accounts Receivable and Prior Authorization staff.
• Researches and resolves any assigned coding related projects.

SKILLS & ABILITIES:

Education and Experience:

• High School Graduate or General Education Degree (GED).
• Two - Four years related experience.
• Knowledge of CPT/HCPC and ICD9/10 codes.
• Ability to understand the billing specialties involved (Chemo, RO, Rheumatology, Radiology, etc.).
• Ability to read and interpret documents such as operating and maintenance instructions, and policy and procedure manuals.
• Ability to add, subtract, multiply and divide in all units of measure, using whole numbers.

Computer Skills:

Basic computer skills, Billing Software.

Certificates & Licenses: