Coder I - Outpatient

SUMMARY

Resolves complex coding scenarios. Provides feedback and documentation advice to the physician and practice management. Works with AR to resolve coding related denials. Serves as liaison between the practice and Physician Network Services and/or other departments

SPECIFIC DUTIES MAY INCLUDE:

Reviews and codes complex operative procedures for all service lines

Assist and direct specialty practices or other appropriate staff in surgical documentation, billing, coding, and reimbursement issues

Assists in the auditing of all service lines

Work in conjunction with billing staff on follow up and resolution of coding related denials and rejections

Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-9/ICDD-10 materials, the Federal Register, and other pertinent materials

QUALIFICATIONS

Minimum education: must be high school graduate or GED required

Certified professional coder (CPC) certification required

2 years CPT, HCPCS and ICD-10-CM coding experience preferred

Use of typing, computer and other office skills in everyday job performance, one to two years previous experience in computer billing, filing, typing, etc.

Reimbursement of third party carriers and other insurance knowledge preferred