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
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.
Abstract the appropriate evaluation and
management level of service from the medical record per CPT instructions.
Understand and adhere to CPT and ICD-10-CM
instructions, the appropriate use of modifiers, and multiple or add-on
Be knowledgeable of Medicare's
guidelines for Teaching Physicians and Residents and their application in the
Assure healthcare provider compliance
with official coding guidelines as well as Medicare and Medicaid requirements
for coding and billing.
Identify and educate healthcare
providers on additional revenue opportunities. Other tasks as assigned.
ESSENTIAL SKILLS AND
CPC or five years of experience with
evaluation and management or
Equivalent combination of experience,
education, and training that would provide the required knowledge and
Three years’ experience as a Certified
Coder/Chart Auditor in a Cardiology setting
Knowledge of ICD-10-CM and CPT coding
guidelines along with modifier usage; medical terminology; anatomy and
Ability to research and analyze data,
draws conclusions, and resolves issues
Ability to read, interpret and apply
policies, procedures, laws, and regulations.
Strong managerial, leadership, and
Excellent written and oral
Moderate – Intermediate computer