Certified Coder (Central Billing Office)

Summary of Duties

Gathers charge information, codes and/or over‑codes physicians’ coding, enters charges into the AthenaNet billing system, completes the billing process including entering insurance information, keying of claims, and other billing/coding duties as assigned.

Supervision

• Reports to Coding Supervisor
• No supervision exercised

Physical Demands and Working Conditions

• Requires sitting for long periods of time and working in an office environment.
• Some bending and stretching required.
• Ability to use a wide array of office equipment including, but not limited to, a PC, copier and fax.
• Manual dexterity required for use of calculator, mouse and computer keyboard.
• Normal office environment.

Examples of Duties

• Maintains patient checklist as assigned to account for all charges through AthenaNet, missing‑bill‑slip work list.
• Works rules as assigned and codes/over‑codes claims as assigned.
• Researches all information needed to complete the billing process, including review of the completed medical record to determine level of service, procedures, and diagnoses.
• Reviews/interprets all completed clinical documentation to determine level of service, procedures, drugs/medicine provided and accurately assigns CPT, HCPCS, and ICD‑10 codes, then creates the claim in AthenaNet.
• Communicates with physicians regarding questions pertaining to procedures and other services to ensure all services are documented during the encounter.
• Reviews all clinical documentation assigned to ensure compliance with third‑party and regulatory guidelines, including “Incident to” when applicable.
• Responsible for accuracy of patient demographics, insurance information, etc., including proper order of primary vs. secondary insurance and verification of benefit details (PCP, HMO plans, traditional, secondary qualifier, etc.).
• Participates in educational activities such as coding teleconferences and continuing education units (CEUs) to maintain certification through professional affiliations.
• Maintains strictest confidentiality and abides by HIPAA regulations.
• Performs related work as required/assigned.

Job Requirements

Knowledge, Skills and Abilities:

• Knowledge of billing practices and clinic policies and procedures.
• Knowledge of coding and clinic operating policies and procedures.
• Knowledge of CPT, ICD‑10, and HCPCS manuals.
• Strong working knowledge of medical terminology and anatomy.
• Knowledge of insurance and third‑party payer requirements.
• Skill in using computer and calculator.
• Ability to examine documents for accuracy and completeness.
• Ability to work effectively with co‑workers as a team member.
• Ability to communicate clearly.

Education: High school diploma or GED.

Experience: Two or more years of coding experience in a healthcare organization. Ability to gather and interpret clinical data and communicate required clinical documentation improvement (CDI) to physicians and non‑physician providers.

Certificate/License: CPC‑A or CPC through AAPC; CCA through AHIMA.

Compensation and Benefits

Excellent pay and benefits, including medical, dental, vision, short‑term disability, life insurance, and 401(k).

Schedule

Monday – Thursday 7:45 am – 5:15 pm; Friday 8:00 am – 12:00 pm (half day). No weekends. Remote work available once trained.