SUMMARY
Certified Coder CPC or Auditor reviews
codes submitted by physicians and other healthcare providers to assure accurate
assignment of ICD-10 and CPT codes for inpatient/outpatient professional
charges submitted via encounters, super bills and reports; maintains compliance
with Federal, State and payer regulations.
Responsible for Provider Education for Clinical Documentation and ICD 10
support.
POSITION RESPONSIBILITIES
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Ability to review and analyze
encounters, reports and other medical records to determine the appropriate
diagnosis and procedure codes to describe the level of service and surgical
professional services provided.
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Abstract the appropriate evaluation and
management level of service from the medical record per CPT instructions.
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Understand and adhere to CPT and ICD-10-CM
instructions, the appropriate use of modifiers, and multiple or add-on
procedures.
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Be knowledgeable of Medicare's
guidelines for Teaching Physicians and Residents and their application in the
teaching environment.
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Assure healthcare provider compliance
with official coding guidelines as well as Medicare and Medicaid requirements
for coding and billing.
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Identify and educate healthcare
providers on additional revenue opportunities. Other tasks as assigned.
ESSENTIAL SKILLS AND
EXPERIENCE
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CPC or five years of experience with
evaluation and management or
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Equivalent combination of experience,
education, and training that would provide the required knowledge and
abilities.
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Three years’ experience as a Certified
Coder/Chart Auditor in a Cardiology setting
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Knowledge of ICD-10-CM and CPT coding
guidelines along with modifier usage; medical terminology; anatomy and
physiology
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Ability to research and analyze data,
draws conclusions, and resolves issues
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Ability to read, interpret and apply
policies, procedures, laws, and regulations.
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Strong managerial, leadership, and
interpersonal skills.
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Excellent written and oral
communication skills.
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Moderate – Intermediate computer
skills.