Certified Coder

About the role

Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri. The coder ensures appropriate levels of service are billed according to American Medical Association (AMA) and Center for Medicare and Medicaid Services (CMS) guidelines, supports insurance credentialing, and provides provider and staff education related to coding and billing guidelines.

Responsibilities

• Assigns ICD-10-CM, CPT, and HCPCS Level II codes to completed and signed medical documentation to create appropriate medical claims.
• Abstracts specified data and information from patient records to determine appropriate modifiers for claim submission.
• Queries providers for clarification of documentation when unclear or inadequate to ensure accurate coding; requests providers to complete addendums as necessary.
• Stays up-to-date with ICD-10-CM, CPT, HCPCS Level II, AMA, CMS, and other federal, state, local, and Phelps Health-specific coding guidelines, rules, and regulations; applies these to all types of patient accounts.
• Abides by AAPC’s “Standards of Ethical Coding” and Phelps Health’s Corporate Compliance coding guidelines.
• Monitors provider documentation for timely completion; notifies Coding Manager of any providers who fall outside the designated 73-hour turnaround time frame.
• Maintains the designated 3-business-day time frame for coding completed records and provides weekly report summaries to the Coding Manager.
• Maintains productivity standards as set forth by the Phelps Health productivity matrix.
• Maintains annual certification through AAPC or AHIMA and completes required CEUs for certification maintenance.

Requirements

• High school diploma or equivalent required.
• Minimum 1-year medical coding experience is preferred.
• Certification as a medical coder through AAPC (CPC, CCS-P, etc.) or AHIMA (CCS, CCS-P, etc.).

Skills

• Considerable mental concentration for sustained periods with attention to detail.
• Ability to handle pressures of time, accuracy, and interruptions.
• Must handle confidential material appropriately.
• Long periods of sitting; occasional standing, walking, reaching, bending, and stooping.
• Good vision, finger dexterity, and complete use of hands and arms.
• Approximately 80% of working time is spent at a computer.
• Strong customer service skills and patience to deal with difficult situations.

Working Conditions

• Remote office conditions; home office must be in a private location due to HIPAA.
• Computer screens should not be visible to others walking by.
• Equipment is provided by Phelps Health.