District Medical Group
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Certified Coder I
at District Medical Group
Essential Duties and Responsibilities:
The Certified Coder I is responsible for reviewing codes submitted by physicians/providers to assure accurate assignment of ICD-9-CM, ICD 10 and CPT codes for inpatient/outpatient professional charges submitted via encounters, superbills and/or reports. Maintain compliance with Federal, State and payer regulations.
- Review encounters, superbills, reports and medical records to assign appropriate billing and diagnosis codes for provider services.
- Abstract documents to determine appropriate level of E/M service or CPT procedure as appropriate.
- Track inappropriate or incorrect codes chosen by providers to report services and follow all company and compliance policies with regards to incorrect codes or patterns of incorrect coding.
- Reviewing physicians’ notes and charts for accuracy
- Obtaining any necessary clarification of information on the notes and charts
- Ensuring that all medical records have been signed by the appropriate parties
- Assigning appropriate medical codes to all diagnoses or services
- Enter and organize the codes into management software
- Perform related duties as assigned by Coding Manager.
- Maintain compliance with Federal, State and payer regulations.
- Maintain compliance with all company policies and procedures.
- One year of medical coding experience preferred.
- One year E&M coding required
- One year experience in medical billing preferred
- Prior experience with IDX, EPIC and EncoderPro preferred.
- High school diploma or equivalent
- Certified Coding Specialist (CCS), or Certified Professional Coder (CPC) required.
- Working knowledge of anatomy, medical and procedural terminology.
- Must have knowledge in ICD-10-CM and CPT-4 coding.
- Knowledge of medical billing practices.
- Computer proficiency (MS Office – Word, Excel and Outlook)
- Understanding/compliance of HIPAA laws and regulations.
- Able to differentiate between primary and secondary insurance payers
- Excellent interpersonal skills.
- Excellent verbal and written communication skills.
- Ability to read, understand and follow oral and written instructions.
- Must be well organized and detail-oriented.
- Must be able to work under pressure and meet deadlines, while maintaining a positive attitude.
- Must be able to work extended hours.
- Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.
- Able to work in a team environment.
- Ability to operate standard office machines and equipment, including telephones, computers, copy machines, fax machines, calculators, scanners and shredders.
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
- Type minimum __35__wpm
- Ten key by touch
- Must be able to lift and carry up to 20 lbs
- Must be able to talk, listen and speak clearly on telephone
- Requires sitting and standing associated with a normal office environment.
- Manual dexterity needed for using a calculator and computer keyboard.
- Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus.
Environmental Working Conditions:
- Normal office environment.
- The noise level of the work environment is usually moderate.
- Occasional overtime maybe required and/or hours may be shortened as business needs dictate.
*The job holder must demonstrate current competencies applicable to the position.