Certified Coder I
4 weeks ago
Position Summary
The Certified Coder I is responsible for providing documentation review, coding, and data abstracting of medical service documentation to ensure that Caris Life Sciences receives appropriate reimbursement and conforms to applicable guidelines and regulations. The role requires technical coding expertise and willingness to provide assistance to others. This position is in a computer based billing/coding environment.
Job Responsibilities
Reviews and analyzes medical information from medical records against billed procedures to ensure accurate coding of diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements.
Review clinical documentation and diagnostic results as appropriate to exact data for accurate ICD-10 Coding
Validate each line was coded with the appropriate diagnosis, procedure, and revenue code and that the ICD-10 diagnosis and procedure codes were coded and sequenced correctly to achieve the appropriate MS-DRG, AP-DRG, or APR-DRG.
Makes corrections as needed to ensure accurate billing and reimbursement processing
Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes.
For all assigned records assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
Prepare reports of findings and share with the Managers and assist the Managers in providing feedback and remediation to reviewers.
Identify and report quality concerns and errors to Clinical Process Quality Analyst for review and education.
Responsible for providing coding support to the Accounts Receivable Team.
Performs all other related duties as assigned.
Required Qualifications
High school diploma or GED
Current Certification as a Certified Coding Specialist (CCS), Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA)
Knowledge of anatomy and physiology, medical terminology, surgical terminology, pharmacological terminology, patient care documentation terminology, ICD-10-CM and CPT codes.
Analytical ability to interpret data contained in records and assign appropriate codes.
Knowledge of ICD-10 coding systems and MS Diagnostic-Related Groups and APC's.
Ability to identify non-compliance in areas of coding practices and medical record documentation.
Proficient in 10 key and alpha/numeric data entry.
Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook.
Conditions of Employment: Individuals must successfully complete pre-employment process, which includes criminal background check, drug screening, and reference verification.
Preferred Qualifications
A minimum of 1 to 2 years of relevant work experience in a healthcare coding.
Ability to work independently with a high degree of attention to detail and reliable decision making.
Ability to work in a fast-past, deadline driven environment.
Drive for Results (Service, Quality, and Continuous Improvement) – Ensure procedures and processes are in place that lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
Communication – Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results.
Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.
Other
This position requires periodic travel and some evenings, weekends and/or holidays.
This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
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