This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
This position involves accurately applying official coding conventions and rules established by the American Medical Association (AMA) and the Center for Medicare and Medicaid Services (CMS) for assignment of procedural and diagnostic codes.
• Reviews surgical documentation for accurate assignment of ICD-10 diagnosis, current procedural terminology (CPT-4) codes, and modifiers.
• Ensures appropriate coding of evaluation and management services when applicable.
• Reviews surgical documentation to assign accurate CPT-4 procedure codes and appropriate modifiers for procedures in the operating room, as well as complex procedures performed in a procedure room.
• Assigns primary and secondary ICD-10CM diagnosis codes.
• Analyzes provider documentation to ensure the appropriate Evaluation and Management codes are assigned.
• Ensures compliance with national coding guidelines and Capital Health's policies for complete, accurate, and consistent coding resulting in appropriate reimbursement and data integrity.
• Reviews CCI edits, MUE edits, LCD, and NCD coverage before chart finalization.
• Contacts and collaborates with appropriate personnel for documentation insufficiencies and to expedite resolution of accounts.
• Maintains level of expertise through continuing education and appropriate productivity levels.
Qualifications
• High school diploma or GED.
• CPC-A, CPC, or CCS-P certification required.
• Associate's degree in Health Information Management preferred.
• Two years of experience in physician coding role preferred.
• Outpatient ICD-10, CPT-4, and HCPCS coding experience preferred.
• One year surgical coding experience preferred.
• Excellent verbal and written communication skills.
• Strong knowledge of surgical coding guidelines.
• Knowledge of pathophysiology and disease processes.
• Physician coding and Training certification.
• Proficient with Microsoft applications including Outlook, Word, Excel, PowerPoint, or Access.
• Knowledge of Medical Terminology, Anatomy and Physiology, or Pathophysiology.
• Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P) required.
• Ability to work collaboratively with others as well as independently.
Requirements
• Usual Work Day: 8 Hours
• Does this position formally supervise employees? No
Benefits
• Retirement Savings and Investment Plan
• Disability Benefits – Short Term Disability (STD)
• Sick Time Off
• Employee Assistance Program