Patient Account Coder

About the role

This position codes conditions and procedures as documented by clinics using the appropriate classification system. It also involves handling non-medical aspects of hospitalization related to payment for care and treatment, maintaining cooperative relationships with patients and their families, and facilitating payment for hospital care and services.

Responsibilities

• Code and submit claims, ensuring codes are accurate and sequenced correctly in accordance with government and insurance regulations.
• Follow up with providers on any documentation that is insufficient or unclear and communicate with other clerical staff regarding documentation.
• Search for information in cases where coding is complex or unusual.
• Review the previous day’s batch of patient notes for evaluation and coding.
• Ensure that all codes are current and active.
• Contact self-pay patients during hospitalization to answer questions regarding costs and billing and discuss financial arrangements for treatment and care.
• Arrange for payment by self-pay patients in accordance with established guidelines.
• Advise patients and their families regarding available financial benefits and resources.
• Collect on delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up when payment lapses occur.
• Submit claims electronically and/or on paper to the patient’s insurance carrier for both primary and secondary claims.
• Access various internet websites to determine claim eligibility status, third-party regulations, updates, and newsletters.

Requirements

• Graduation from high school or possession of an equivalency diploma, and either:
  • Certification through the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) and one year of clinic coding experience; or
  • Two years of full-time paid experience in the preparation and maintenance of medical records in a healthcare setting, which involved coding and indexing of medical procedures, filing and maintenance of health facility medical records, analysis and evaluation of medical records, and electronic health facility medical records use; or
  • An equivalent combination of training and experience as defined by the above options.