|Employer:||Meridian Medical Management
|Required Certifications:||CPC or equivalent
|Required Experience:||1 to 2 years
|Preferred Experience:||3 to 4 years
The certified coder utilizes knowledge of specialty coding to analyze patient medical records, ensuring documentation by providers conforms to procedural requirements. You will assign specified codes to medical diagnosis and/or clinical procedures. The certified coder utilizes industry standard best practices, analyzes and interprets patient medical records for orthopedic surgeries and office encounters in order to determine amount and nature of billable services. You will consistently maintain pre-defined productivity and performance measures, to maximize accurate reimbursement and accelerate cash collections. The certified coder collaborates with Meridian to ensure a unified approach to the delivery of service, and models the organization’s mission to improve physicians’ profitability and business processes through best-of-breed technology, service and information.
MAIN POSITION REQUIREMENTS:
- Utilizes knowledge of medical codes and coding procedures to assign and sequence appropriate CPT/ICD-10 codes, in compliance with government and third party payer requirements.
- Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation. Communicates with Coding Manager and Director on any problematic areas.
- Monitors billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices.
- Finds missing charges by using available hospital system links.
- Work accounts in the claim scrubber queues.
- Follows established departmental policies, procedures, and objectives, including continuous quality improvement objectives.
- Communicates with departmental heads and other administrative staff, in review of diagnosis/procedure code denials.
- Communicates with Client, as appropriate, to clarify coding discrepancies and ensure changes are documented by Client.
- Enter charges & documents all account activity in accordance with company Documentation Standards.
- Identifies appropriate escalation points and works with management to resolve issues.
- Assists with the identification of trends and root cause analysis, relative to coding, and communicates with Management to reduce reimbursement delays and minimize denials.
- Consistently meets pre-defined productivity metrics and performance standards.
- Performs all responsibilities, in accordance with Policies and Procedures, and within the appropriate scope of practice, as designated by the level of professional credentialing and State Specific Scope of Practice Guidelines.
- Ensures compliance with HIPAA Privacy and Security Policies and Procedures.
- High School diploma or GED required; college degree preferred.
- At least two years’ experience coding Orthopedic surgical cases and E/M services; outpatient and inpatient.**
- Ability to gather data, compile information in an organized fashion.
- Knowledge of current and developing issues and trends in medical coding procedures.
- Knowledge of medical coding procedures, systems, and regulatory issues within multi-specialties.
- Knowledge of anatomy and physiology.
- Ability to use independent judgment to manage and impart confidential information and clearly communicate medical information to professional practitioners.