GENERAL STATEMENT OF
DUTIES:
This position is responsible for ensuring efficient claims processing for
services provided.
SUPERVISION RECEIVED: Medical Coding
Manager
PHYSICAL/ENVIRONMENTAL CONDITIONS: The work environment
is that of an office environment typical of a medical practice, hospital or
clinic. The job requires extended
periods of sitting, some standing, bending, stooping and walking. Work may
require hand dexterity for telephone and office machine operation as well as
computer keyboarding. Work may be stressful at times. Interaction with others is constant and
interruptive.
MACHINES/EQUIPMENT
USED:
Clinical and office equipment {if any needed}.
ESSENTIAL FUNCTIONS
AND RESPONSIBILITIES: (This list may not
include all of the responsibilities assigned.)
1.
Keeps
current on CPT, ICD9/ICD10
compliance and editing guidelines.
2.
Provide
training to physicians and staff regarding regulatory issues and compliance.
3.
Keeps
current on all regulatory issues and provides feedback to staff.
4.
Leads
auditing of physician services to verify accuracy of billing.
5.
Schedules
annual audit for all physicians and participates in presenting results.
6.
Works
with or assists other Medical Coders and trainers in Coding department.
7.
Schedules
follow-up audits for physicians not meeting clinic established standards of
accuracy
8.
Works
with other coding department coders and auditors to verify accuracy of audits.
9.
Assists
in assigned edits to keep department current, and to identify trends for
further auditing
10. Provides exemplary
customer service to patients and staff.
11. Participates in
department quality improvement, clinic safety, infection control and hazardous
materials programs and activities.
12.
Attends required meetings and participates in committees as
requested.
13.
Adheres to HIPAA regulations.
14.
Exercises discretion and maintains high level of
confidentiality.
15.
Adheres to all policies and procedures.
16.
Performs related work as required.
KNOWLEDGE, ABILITIES, AND SKILLS: This position will
have a combination of education and experience to demonstrate competency in the
methods, policies, procedures, regulations and protocols of a Claims function.
High degree of tact and diplomacy, clear and concise communications skills, proficiency
in mathematics, ability to follow established protocols and procedures
repeatedly and within established error tolerances, and good decision making
within established guidelines. High level of computer competency and attention
to detail. Keyboard and ten-key by touch.Able to speak, read, comprehend (and
be comprehended) in English. Ability to organize and prioritize work. Ability to follow oral and written
instructions. Ability to reason and make
sound judgments. Skill in identifying problems and recommending solutions.
Skill in establishing and maintaining effective working relationships with
co-workers, management, patients, medical staff, and the public. Skill in
accepting constructive criticism and giving suggestions in a professional manner.
EDUCATION, EXPERIENCE AND LICENSURE:
·
Minimum
requirement graduation from High School or equivalent (some post secondary work
preferred).
·
Four
or more year’s prior coding experience and a Certification or Credential as a
Procedure Coder. AAPC licensing
preferred.