Certified Coder

Job Description

SUMMARY: The Certified Coder (Office) is responsible for reviewing documentation of services rendered by Providers and entering the appropriate CPT, ICD-10-CM, and HCPCS codes into the EHR system for claims processing. This position applies his or her deep knowledge of coding, billing, and payer guidelines to maximize reimbursement, and serves as an educational resource to providers, clinical, and billing staff.

ESSENTIAL DUTIES:

1. Collects documentation of services rendered by Providers.

2. Accesses and reviews hospital records to obtain and verify pertinent details (inpatient dates, payer authorizations, registration changes, correct diagnoses) for successfully dropping the claim.

3. Gathers clinical documentation (physician consults, imaging reports, operative reports, pathology reports, etc.) to support CPT and diagnoses codes, and refers any discrepancies to provider for clarification and permission to bill.

4. Enters the appropriate CPT, ICD-10-CM, and HCPCS codes into the EHR system in a timely manner. Utilizes knowledge of coding, billing, and payer guidelines to maximize reimbursement.

5. Monitors the claims hold bucket, researches claim denial reasons, and resolves issues in a timely manner.

6. Works closely with the Central Business Office to stay abreast of revisions to coding guidelines; notifies providers, clinical, and billing staff of changes.

7. Addresses patient questions and concerns regarding billing in a kind, courteous manner.

8. Monitors and responds to assigned tasks in the EHR in a timely manner.

9. Reviews daily batches from charge entry staff, including verifying monies and identifying charge entry errors.

10. All other duties assigned by supervisory personnel.

NOTE: The above stated duties are intended to outline those functions typically performed by individuals assigned to this classification. This description of duties is not intended to be all-inclusive or to limit the discretionary authority of supervisors to assign other tasks of similar nature or level of responsibility.

QUALIFICATIONS:

Education:

11. High school diploma or GED

12. CPC Certification - Certification must remain in good standing

Experience:

13. One year of previous experience in the medical field.

14. Basic knowledge of the use and operation of general office equipment (computer, phone, copier, fax)

15. Working with the public in a courteous and professional manner.

16. Working knowledge of federal, state and local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations preferred but not required.

Skills:

17. Ability to maintain a positive attitude and provide great customer service under stressful situations.

18. Ability to communicate in a clear, concise, and pleasant manner in both verbal and written form.

19. Ability to multi-task.

20. Ability to adapt quickly to change.

21. Ability to work both independently and with co-workers.

22. Ability to use and manage time efficiently.

23. Ability to follow the direction of supervisory personnel.

About Us

Harbin Clinic is made up of 1,300 proud professionals, each one All In to care completely for the people of Northwest Georgia. We offer competitive pay and benefits, a mostly Monday to Friday schedule, and a generous uniform allowance, along with the unique opportunity to learn and grow across more than 40 different medical specialties and services. Harbin Clinic seeks talented, invested individuals to become part of our healthcare team. Join us as we work to see our communities flourish

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