Certified Professional Coder

Job Description

Description:

*** MUST RESIDE IN TEXAS***

Job purpose

The certified coder prepares and submits clean claims to insurance companies electronically and by paper, and provides appropriate coding for each patient’s medical history, diagnosis, tests and treatment plan.

Duties and responsibilities

Primarily codes from final office visit, surgical/procedural operative reports signed by providers

Reviews medical records and accurately code primary and secondary diagnoses using CPT, ICD-9 and ICD-10 conventions; sequence the diagnoses and procedures using coding guidelines

Verifies accuracy and submits claims to insurance using Electronic Medical Records systems and paper claims

Enters patient copayment information into the EMR

Reconciles charges against the schedule list to ensure no charges are missed

Investigates rejected claims to see why denials were issued as necessary

Re-bills rejected claims in timely manner

Maintains strict confidentiality and high degree of accuracy

Consults classification manuals and relies on knowledge of disease processes

Correlates information from supporting clinical documentation when appropriate

Communicates with clinical, ancillary services and medical personnel for needed documentation

Provides feedback to providers as it pertains to proper coding and clinical documentation

Keeps staff members informed of regulatory changes and updates

Identifies and participates in educational opportunities for self

Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements

Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments

Operates standard office equipment (e.g. copier, personal computer, fax, etc.).

Has regular and predictable attendance

Adheres to Advanced Pain Care’s Policies and procedures

Performs other duties as assignedRequirements:

Qualifications

Education: Requires a high school diploma or GED; current CPC certification required

Experience: Prior medical coding experience required; must be familiar with correct billing techniques, CPT, ICD-9, ICD-10 coding, electronic medical records and strong knowledge of medical terminology.

Knowledge, Skills and Abilities:

Extensive knowledge of coding in-office and surgical procedures and applicable modifiers

Advanced knowledge of ICD-9-CM & CPT-4 coding conventions

Knowledge of Anatomy and Physiology

Knowledge of Medical Terminology

Knowledge of EMR systems and Microsoft software applications

Effective written and verbal communication skills

Data entry skills and ability to type 50+ wpm

Proficient in using 10 key and doing basic arithmetic

Ability to maintain patient confidentially and comply with HIPAA guidelines

Time management skills and ability to work efficiently to complete tasks

Excellence in customer service

Working conditions

Environmental Conditions: Medical Office environment

Physical Conditions:

Must be able to work as scheduled – typically from 8:00 – 5:00 M-F

Must be able to sit and/or stand for prolonged periods of time

Must be able to bend, stoop and stretch

Must be able to lift and move boxes and other items weighing up to 30 pounds.

Requires eye-hand coordination and manual dexterity sufficient to operate office equipment, etc.

Full-time