|Employer:||Clinicas del Camino Real, Inc.
|Skills:||Medical Coding,Good math skills,Effective communication skills
|Required Experience:||1 to 2 years
|Preferred Experience:||3 to 4 years
Under the general supervision of the Revenue
Cycle Manager, reviews, analyzes and assures the final diagnoses and
procedures as stated by the practicing providers are valid and complete.
Accurately codes office and hospital procedures for providers to ensure
proper reimbursement. Provides education to the providers to ensure
proper completion of Electronic Health Records and proper assignment of
ICD-9-CDM and ICD-10-CDM, HCPCS and CPT codes.
The Medical Coder is responsible for the following:
- Audits records to ensure proper submission of services prior to billing on pre-determined selected charges
- Receives hospital information to properly bill provider services for hospital patients
- Supplies correct ICD-9—CM /ICD-10-CM diagnoses codes to all diagnoses provided
- Supplies correct HCPCS code on all procedures and services performed
- Supplies correct CPT code on all procedures and services performed
- Contacts providers to train and update them with correct coding information
- Attends seminars and in-services as required to remain current on coding issues
- Audits medical records to insure proper coding completed and to ensure compliance with federal and state regulatory bodies
- Maintains all mandatory in-services
- Maintains compliance standards in accordance with compliance
policies and the Code of Conduct. Reports compliance problems
- Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.
- Quantitative analysis – Performs a comprehensive review for the
record to assure the presence of all component parts such as: patient
and record identifications, signatures and dates where required, and all
other necessary data in the presence of all reports which appear to be
indicated by the nature of the treatment rendered.
- Qualitative analysis – Evaluates the record for documentation
consistency and adequacy. Ensures that the final diagnosis accurately
reflects the care and treatment rendered. Reviews the records for
compliance with established reimbursement and special screenings
- Analyzes provider documentation to assure the appropriate Evaluation
& Management (E&M) levels are assigned using the correct CPT
- Performs other duties as assigned, including participation in all
safety and compliance programs which may include assignment to an
emergency response team.
- High School Diploma
- Medical Coding Certificate – RHIT or CPC certification is preferred
- Excellent interpersonal skills
- Two years’ experience using ICD-9-CM, HCPCs or equivalency
- Computer competency
- Knowledge of federal laws and regulations affecting coding requirements
- Knowledge of principles, practices and methods of current coding certificate required
- Knowledge of billing practices required, FQHC billing preferred
- Knowledge of medical records, HER required
- Extensive knowledge of official coding conventions and rules
established by the American Medical Association (AMA), and the Center
for Medicare and Medical Services (CMS) for assignment diagnostic and
- Must have good math skills and affective communication skills.