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Certified Medical Coder

4 months ago

North Little Rock, United States OrthoArkansas Full time
Job DescriptionJob Description

General Description of Position:

The Certified Medical Coder plays a crucial role in reviewing clinical documentation and applying appropriate billing and diagnostic codes according to accepted guidelines. This position involves close communication with providers to identify missed billing opportunities and collaboration with insurance collectors to address denied claims related to coding and medical necessity.

Essential Duties and Responsibilities:

  1. Coding and Documentation:
    • Code and enter assigned clinical, hospital, and surgical charges for designated physicians.
    • Review and verify information imported into the practice management system, ensuring only relevant data remains in the patients' charts.
    • Assist pre-certification departments and financial counselors with CPT and ICD-10 codes for upcoming procedures.
    • Maintain a coding spreadsheet to track all charges received, missing, coded, and keyed.
  2. Patient and Provider Support:
    • Build new charts for all new patients seen in the hospital.
    • Provide on-site staff with assistance for urgent coding issues.
    • Assist in coding and entering surgical and hospital charges as time permits.
  3. Claims and Appeals:
    • Review denied procedures for possible appeals and communicate findings with collectors.
    • Ensure all DME charges are keyed timely by reviewing the BREG spreadsheet.
    • Maintain and appropriately distribute the SVI uninsured spreadsheet.
  4. Quality and Professional Development:
    • Achieve and maintain a 95% accuracy rate on all coding with a 2-3 day turnaround time, provided documentation is available.
    • Attend orthopedic coding seminars as required, which may involve some travel if local options are not available.
    • Self-manage, initiate tasks, be punctual, and pay close attention to detail.
  5. Miscellaneous:
    • Perform any other related duties as required or assigned.

Qualifications:

  • Education and Experience:
    • High school diploma or GED.
    • Specialized schooling and/or on-the-job education in data processing, clerical/administrative tasks, equipment operation, etc.
    • Minimum of 2 years of related experience and/or training, or an equivalent combination of education and experience.
    • Thorough knowledge of orthopedic procedures/diagnoses and procedure codes.
    • Ability to interact professionally and diplomatically with physicians, hospitals, insurance companies, and coworkers.
    • Extensive knowledge of medical terminology.
    • Excellent written and oral communication skills.
    • Physician coding and billing experience.
  • Certificates, Licenses, Registrations:
    • Required: Certified Professional Coder (CPC) through AAPC, ICD-10 certification if credentialed prior to 2015.
    • Preferred: Not indicated.
  • Software Skills Required:
    • Advanced: 10-Key.
    • Intermediate: Accounting, Alphanumeric Data Entry, Database, Spreadsheet, Word Processing/Typing.

This position demands a detail-oriented professional capable of ensuring accurate and timely medical coding, effective communication with healthcare providers and insurance companies, and maintaining high standards of documentation and patient care.