Coder

Job Purpose

The Coder will utilize their coding proficiency to conduct detailed invoice reviews and offer expert guidance to the billing team. This role is crucial for ensuring accurate claim processing and payment.

Duties and Responsibilities

• Perform comprehensive audits and coding reviews to verify the accuracy and precision of all documentation, including that from co-source partners.
• Accurately assign and sequence CPT and ICD-10 codes for all rendered services as required.
• Collaborate closely with billing staff and manage system work queues to ensure the proper and timely payment of claims.
• Adhere strictly to all Medicare policy requirements, encompassing coding initiatives and guidelines.
• Manage and complete assigned tasks independently from designated work queues.
• Maintain strict confidentiality of all information at all times.
• Uphold a professional demeanor and attitude in all interactions.
• Undertake other duties as assigned by the management team.
• Safeguard and disclose patients' protected health information (PHI) strictly in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Understand and comply with all Information Security and HIPAA policies and procedures.
• Limit access to PHI to the minimum necessary to perform assigned duties.

Qualifications

• Possession of a CPC certification from AAPC or a CCS certification from AHIMA is required.
• High School graduate or equivalent is a prerequisite.
• A minimum of two years of coding experience is necessary, specifically related to the specialty required (e.g., IP DRG, OP, Denials, SDS).
• Proficiency in Microsoft Word, Outlook, and Excel is essential.
• Must be capable of utilizing job-related software effectively.
• Surgical coding experience is considered a strong advantage.
• Exhibit strong interpersonal skills, with the ability to communicate effectively across all levels of the organization.
• Demonstrate robust problem-solving and creative skills, with the capacity to exercise sound judgment and make informed decisions based on accurate and timely analyses.
• Possess a high level of integrity and dependability, coupled with a strong sense of urgency and a results-oriented approach.
• Excellent written and verbal communication skills are mandatory.
• A gracious and welcoming personality is beneficial for customer service interactions.

Working Conditions

Physical Demands

While performing the duties of this job, the employee may occasionally be required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computers, computer peripherals, and telephones; extend arms; kneel; talk and hear.

Mental Demands

The employee must be able to follow directions, collaborate effectively with others, and manage stress.

Work Environment

The noise level in the work environment is typically minimal.