CERTIFIED CODER

POSITION TITLE: Certified Coder REPORTS TO (TITLE): Director of Revenue Cycle HOURLY RANGE: $31.00 - $42.74 DOE Job Summary: The Certified Professional Coder is accountable for ensuring coding compliance for services performed by physicians and non-physician providers (e.g., nurse practitioners and physician assistants) and adhering to government regulations and coding guidelines.

This position requires current, in-depth knowledge of coding governmental and commercial rules and regulations, including regulatory compliance requirements.

Specific Tasks/Duties Include: * Perform physician/non-physician provider documentation audits for compliance and regulatory requirements.

* Perform coding data audits to validate documentation supports services rendered for reimbursement and reporting purposes.

* Perform medical record review to abstract information required to support accurate coding for professional provider encounters.

* Identify documentation deficiencies and properly query providers for proper code capture.

* Partake in educating and training providers and other professionals in appropriate coding * Researches, analyzes, recommends, and facilitates a plan of action to correct discrepancies and prevent future coding errors.

* Assigns accurate CPT, HCPCS, and ICD medical codes for diagnoses and procedures.

* Ensure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations.

* Code review for medical necessity, claims denials, billing issues, and charge capture.

* Assist in the development and implementation of policy and procedures for the understanding of how to integrate medical coding and payment policy changes into the practice's reimbursement processes.

* Assist in the integration of coding and reimbursement rule changes and updating the Charge Description Master (CDM), including the appropriate application of modifiers.

* Assist in regular, weekly/monthly meetings with departmental site directors and medical directors and provides information related to coding review findings and regulatory coding updates.

* Serves as resource and subject matter expert to other staff.

* Provides ongoing support and training on all aspects of medical coding.

* Other duties as assigned by Director of Revenue Cycle.

Education and Experience: * CPC Certification required * COC Certification preferred but not required * CPMA Certification preferred but not required * At least 4 years of experience in physician/non-physician provider documentation review and ensuring coding compliance, to government regulations and coding guidelines within the healthcare industry, preferably in an FQHC setting.