Medical Coder

Key Responsibilities

• Review physician dictation for office and hospital visits
• Verify and make sure that the appropriate CPT/HCPC/ICD-10-CM codes have been chosen to ensure visit meets criteria for the level chosen
• Post Co-Pay Payments when applied to encounters during coding
• Review, code, and post charge for all events in NextGen (including Hospital, ASC, Clinic, and Radiology)
• Review and Correct ALL Coding Denials as needed and assigned in WorkLog (including Assisting Billing with Appeals as needed)
• Locate corrections or additions needed in dictation, and send requests to physicians and Transcription Department for necessary changes and or addendum
• Answer questions on CPT/HCPC/ICD-10-CM codes needed by other departments
• Work in conjunction with Pre-Coding, QA, and Back Office Staff to support, clarify, and charge for the physician’s treatment of each patient encounter
• Follow through and complete missed charges on Unbilled Encounter Report (ie cast applications, DME’s, medications and injections, x-rays)
• Release claims after corrections are made or physician dictates as requested (ie x-rays, visits, medications, injections or casts)
• Know or learn to code per payer while remaining in AMA CPT guidelines
• Attend continuing education to keep current with coding changes and third party payer requirements
• Stay up to date on Coding/Payer Education via the Education Tracking Spreadsheet
• Work closely with the Billing and Coding Manager and Supervisors to interpret third party payer requirements
• Assist to implement procedures that ensure optimum reimbursement in compliance with regulations
• Develop and implement improvements as appropriate
• Provide excellent customer service to staff, leadership, providers and customers
• Assist in maintaining and monitoring department spreadsheets and WorkLog as assigned
• Unbilled Encounters
• WorkLog
• Support other departments company wide in correct understanding and usage of CPT/HCPC/ICD-10-CM codes
• Assist in the Annual Provider Reviews for your assigned physicians
• Participate in quarterly Q&A sessions
• Assist with other duties as assigned
• Assist other departments in understanding and interpreting LCD policies published by CMS
• Assist Pre-Auth Department with CPT/HCPC/ICD-10-CM codes as needed

  Requirements

  • Medical coding certification from AAPC (CPC-A or CPC) or AHIMA (CCA, CCS-P) must be obtained prior to hire
  • Minimum 1 year of experience in the last 18 months in coding physician services and/or physical therapy (PT/OT) services preferred
  • Knowledge of Medicare provider requirements preferred
  • Excellent communication skills
  • Mastery of Microsoft Office Knowledge including Outlook, Excel, Word, Power Point and OneNote
  • Basic computer skills; Microsoft Office Suite