Orthopedic Surgical Coder- Certified Job in Newton, Massachusetts

Summary of Position

 Under general supervision, assigns diagnosis and procedural codes to medical procedures to ensure compliant coding/billing of facility and office based services.  Monitors and reviews all medical records in order to assure the accuracy of medical coding, including appropriate completion and documentation of physician signatures, and proper coding of all diagnoses and procedures.  Thorough understanding of CMS/Medicare regulations, as well as technical knowledge of the International Classification of Disease (ICD-10) and Current Procedural Terminology (CPT-4) classification systems.  Provides billing department with accurate completed coded reports for processing, notifying sites of missing information and following up accordingly. May provide administrative and data entry support as required. Reports to Coding Supervisor.

Essential Functions

 ·Ensures that professional services are captured and coded and ensures coding compliance with federal regulations and insurance requirements. Ensures that CPT and ICD codes are aligned so that there will be no question as to relationship between diagnosis and treatment and the claim will be reimbursed.

·Evaluates and interprets medical records and reports in order to accurately code diagnosis and procedures.  Assesses encounter documentation using Center for Medicare and Medicaid Services (CMS) documentation standards.  Based on provider’s documentation identifies possible documentation changes which, if implemented, would more accurately account for services provided.  Presents findings to provider and works to resolve issue.

·Correctly enters coding information into an EpicCare electronic medical record system.

·Serves as a resource on coding issues.

·Assists with the development of processes and procedures structured to optimize reimbursement, limit liability and enhance data integrity.

·Keeps up to date on billing/coding rules, including the annual update of CPT-4 and ICD-10 codes.  Maintains CEUS needed for certification.

Skills and Experience: At least 2-3 years recent coding experience, experience coding surgical cases preferred. Thorough knowledge of medical terminology, ICD-10-CM and CPT4 coding necessary. Understanding of both the medical and business side of healthcare operations.  Highly organized, self-motivated, detail-oriented and energetic team player.  Ability to multi-task in a fast-paced environment. Excellent verbal and written communication skills.  Must be detail oriented.   Strong computer skills including MS Office, Internet, and E-mail. Excellent problem solving ability and good interpersonal skills. Epic experience helpful