The Certified Coder accurately codes and abstracts office, observation and inpatient records as well as coding general surgical and some complex ambulatory and inpatient procedures (expertise in one or more procedural areas) while entering corresponding charges to achieve complete and compliant coding of assigned provider accounts to meet reimbursement and reporting requirements. Assists with end-of-month and error reconciliation processes, including retrospective verification of medical necessity. Must have the ability to work independently in a fast-paced environment with the skills to prioritize and shift focus as need arises. Must project a mature, customer-focused attitude and professional demeanor in all contacts.
- Minimum three (3) years current provider coding experience in the procedural office setting or a comprehensive ambulatory surgery center in one or more procedural areas
- Two to three years' experience in physician billing preferred
- Expertise in ICD-10-CM and CPT coding principles are essential including knowledge of EM guidelines
- Thorough knowledge of Official Coding Guidelines
- Solid command of medical terminology, human anatomy/physiology, pathophysiology, and disease process
- Typing skills of minimum 30 wpm with Windows based PC knowledge
- Polished communication and customer service skills
- Ability to read and write in English
- Detail oriented, committed to accuracy, ability to problem solve
License or Certification Requirements
- Coding credential (or eligible status) requires
- Registered Health Information Administrator (RHIA). Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) and/or Certified Professional Coder (CPC) or eligible status with achievement of credential within six months of hire
- Accurately assigns and sequences appropriate ICD-10-CM codes for all diagnoses, signs, symptoms and conditions documented in the medical record and addressed by the provider
- Assigns all CPT codes required to accurately and completely report all procedures performed and services rendered by the provider and links each code to the corresponding diagnosis code
- Adds appropriate modifiers to CPT codes to fully describe services rendered
- Reviews and responds to APC, OCE, CCI and medical necessity edits identified during the encoder session to achieve compliant coding and optimize appropriate reimbursement
- Understands and applies recognized coding guidelines and billing requirements for Medicare/Medicaid/HMO/PPO and miscellaneous billing as defined by contract, state or federal law
- Assists in end-of-reporting period, backlog completion, medical necessity verification and error reconciliation processes
- Collaborates with Patient Financial Services and source departments, practices and providers to achieve timely error-free coding and billing
- Activily participates in continuing education opportunities to improve job performance and/or maintain credentialing
Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.
Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago's southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedications is respected, where superior performance is rewarded with competitive salaries and excellent benefits.
Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Required to communicate during presentations/training, telephone communication, and facilitate meetings.
Vision: Needed to read memos and literature, close vision (ability to adjust focus).
Hearing: Needed for telephone communication, meetings, alarms and listening to employee concerns.
Touch: Needed to write, computer entry, filing.
Percentage of time during the normal workday the employee is required to:
Reach above shoulders: 2%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Frequently
Up to 20 lbs: Frequently
Up to 35 lbs: Occasionally
Up to 50 lbs: Occasionally
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Carrying materials such as charts and labels waist high and for approximately 20 feet.
Maximum consecutive time (minutes) during the normal workday for each activity:
Reach above shoulders: 1
Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight: 5-10# frequent
Pushing & pulling Normal weight: <50#>
Fine Manipulation: Computer keyboard, writing, calculator.
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards:
Temperature: Normal Range
Noise levels: Average
Humidity: Normal Range
Protective Clothing Required: None