Certified professional coder job description

Reports to the Manager of Professional Coding. Under general supervision and in accordance with the policies and procedures established by BMG Professional Coding, reviews and accurately codes office and hospital procedures for reimbursement requiring exercise of initiative and judgement.
MISSION, VALUES and SERVICE GOALS

MISSION: We deliver outstanding care, inspire health, and connect with heart. VALUES: Trust. Respect. Integrity. Compassion. SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.


Performs routine and non-routine revenue cycle, billing, coding and insurance functions by:


Extracting relevant information from patient records, examining documents for missing information. Liaison with physicians and other parties to clarify information. Analyzing documentation and accurately applies CPT, ICD, and HCPCS codes to support compliant coding. Working rejected and denied claims based on assigned reports, and assists in complex denial resolution. Communicating updates on coding related changes and billing opportunities and guidelines to supervisor and/or providers. Assisting providers with required documentation, compliant coding and reimbursement. Monitoring provider documentation for trends and adherence to documentation standards and regulatory requirements through report and billing analysis. Communicates results to providers and management as needed. Participating in timely review of provider documentation and communication of results to supervisor. Auditing reports as necessary to identify and correct coding related errors. Achieving BMG's coding productivity and accuracy rates within 6 months of hire; maintains rates as evaluated by internal or external review.


Performs other functions to maintain personal competence and contributes to the overall effectiveness and efficiency of the department by:


Working closely with other BMG Central Business Office associates. Presenting coding and compliance related topics to team members. Completing other job-related duties and projects as assigned.
ORGANIZATIONAL RESPONSIBILITIES



Associate complies with the following organizational requirements:


Attends and participates in department meetings and is accountable for all information shared. Completes mandatory education, annual competencies and department specific education within established timeframes. Completes annual employee health requirements within established timeframes. Maintains license/certification, registration in good standing throughout fiscal year. Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department. Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self. Adheres to regulatory agency requirements, survey process and compliance. Complies with established organization and department policies. Available to work overtime in addition to working additional or other shifts and schedules when required.


Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
Le verage innovation everywhere. Cultivate human talent. Embrace performance improvement. Build greatness through accountability. Use information to improve and advance. Communicate clearly and continuously.



Education and Experience
The knowledge, skills, and abilities are normally acquired through a High School diploma, GED or suitable equivalent. Graduate of an accredited medical coding program preferred. Two years physician coding experience in an applicable specialty preferred. Designation as a Certified Coding Specialist-Physician Based, Certified Professional Coder, Certified Medical Coder, or Certified Coding Associated required. Must complete a minimum of 12 hours of coding related education per year to field of concentration.


Knowledge & Skills


Requires accuracy and proficiency with CPT, ICD and HCPCS code assignment. Demonstrates knowledge of regulatory and payer specific coding guidelines. Demonstrates proficiency in knowledge of anatomy, physiology and medical terminology. Demonstrates exceptional organizational skills and attention to detail. Proficient computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite. Ability to work independently and as a member of a team. Requires excellent communication skills, both oral and written, necessary to effectively speak to a diverse audience. Demonstrates working knowledge of HIPAA and ability to maintain confidentiality of all data.


Working Conditions


Works in an office environment. May experience some mental/visual fatigue from careful and constant review of records, code books, and continued use of computer equipment.


Physical Demands


Requires the physical ability and stamina to perform the essential functions of the position.

Novant Health is seeking a Certified Professional Coder III. Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payers and other regulatory agencies. Functions includes but are not limited to reviewing surgical operative reports and abstracting clinical diagnoses, procedure codes and other pertinent information in order to bill appropriately for services. Will ensure physicians are continually educated on correct coding techniques to maximize reimbursement. Come join a remarkable team where quality care meets quality service, in every dimension, every time.
#JoinTeamAubergine #NovantHealth. Let Novant Health be the destination for your professional growth.

At Novant Health, one of our core values is diversity and inclusion. By engaging the strengths and talents of each team member, we ensure a strong organization capable of providing remarkable healthcare to our patients, families and communities. Therefore, we invite applicants from all group dynamics to apply to our exciting career opportunities.

Qualifications

* Education: High School Diploma or GED, Required.
* Experience: Minimum of four years healthcare experience with at least three years of professional coding experience, Required. Two years of medical terminology experience and three years of customer service experience in a clinic setting, Preferred.
* Licensure/Certification: CPC, CCS-P, COC, RHIA or RHIT, Required.
* Additional Skills (required): Working knowledge of Current Procedure Technology (CPT), ICD-9 and HCPCS coding. Experience with EPIC Resolute Billing preferred. Ability to effectively communicate and work with patients, physicians, staff and administration. Outstanding interpersonal, written and verbal communication skills. Ability to work independently with minimal supervision. Self-audit of work and awareness of impact on revenue cycle is key. Must be professional in demeanor, dress and communication style with the ability to pass a mock feedback session with physicians. Must have the ability to demonstrate knowledge of and utilize, apply, interpret and train on current coding classifications systems and documentation guidelines. Working knowledge of Current Procedure Terminology (CPT), ICD-9, ICD-10 proficiency and HCPCS coding.

Responsibilities

It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.

* Our team members are part of an environment that fosters team work, team member engagement and community involvement.
* The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
* All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of "First Do No Harm".

OA is a privately-owned, regional leader in comprehensive orthopedic care. Since 1985, patients have placed their trust in our specialized care of the hand and upper extremities, spine, shoulder, elbow, hip, knee, foot and ankle, trauma, total joint and sports medicine. With over 30 providers, Orthopedic Associates provides patient care at multiple locations throughout the Miami Valley region. OA is an innovative, progressive, fast-paced practice- always one step ahead in the industry.

Our Vision

To be the region’s most respected leader in comprehensive orthopedic care.

Our Mission

To enhance the lives of our patients by providing individualized, state of the art, compassionate orthopedic care.

We are seeking a motivated candidate who demonstrates Honor, Integrity and Service while developing “Focus” and “Trust” with patients and team members.

Under general supervision, and new leadership, this position would be responsible for the following:

• Reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete.
• Accurately codes office and procedures for providers to ensure proper reimbursement.
• Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD-10 and CPT codes.

Duties include; but are not limited to:

• Audits records to ensure proper submission of services prior to billing on pre-determined selected charges
• Supplies correct ICD-10-CM diagnosis codes on all diagnoses provided
• Supplies correct CPT code on all procedures and services performed
• Contacts providers, minimally quarterly, to train and update them with correct coding information
• Attends seminars and in-services as required to remain current on coding issues
• Audits medical records to ensure proper coding completed and to ensure compliance with federal and state regulatory bodies
• Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
• Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct. Reports compliance problems appropriately.
• Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.

Exciting opportunity comes with full-time, flexible hours (M-F) and a comprehensive benefit package. Orthopedic Associates is an Equal Opportunity Employer.