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 codes
enforcement and maintains all document changes based upon them.
2.
Gives
feedback to and acts as a resource for coding department and providers.
3.
Provides
CPT and ICD9/ICD10 reviews.
4.
Responsible
for coordinating charge sheet changes and modifications at the Clinic.
5.
Assists
with coding improvement measures to maximize reimbursement in A/R.
6.
Works
with all Clinic personnel to resolve coding issues.
7.
Maintains
master files, evaluates and develops improvements, fee ticket systems, serves
as a reviewer of claims.
8.
May
provide training in the Coding department.
9.
Provides
exemplary customer service to patients and staff.
10. Participates in
department quality improvement, clinic safety, infection control and hazardous
materials programs and activities.
11.
Attends required meetings and participates in committees as
requested.
12.
Adheres to HIPAA regulations.
13.
Exercises discretion and maintains high level of
confidentiality.
14.
Adheres to all policies and procedures.
15.
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