Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement.
Coordinates coding across various divisions. Analyzes surgical operative and other notes and documents to determine the scope and complexity of the services provided.
Utilizes professional coding knowledge, applies ICD10/CPT/HCPCs codes to the services delineated in the operative note. Reviews documentation and codes to ensure appropriate capture of all billable services. Provides ongoing feedback and education to the applicable clinical staff regarding appropriate documentation and coding of services.
Acts as the key liaison for the clinical staff as it relates to coding and compliance. Interacts with physicians and other professional staff on documentation issues related to coding data.
Remains current with any changes in ICD-10 and CPT-4 coding and remains current with Medicare, federal insurance and third party billing compliance regulations. Works collaboratively with the Director and coders to ensure all the division charge tickets are compliant, accurate and updated annually or as new procedures are added to the division.
Identifies accurate codes and categories for e-ticket implementation for each division. Maintains accurate and current codes in the system by working collaboratively with IS department. Maintains the department Practice and Procedure manual and updates quarterly with new or modified practices or procedures.
Required Qualifications:High School diploma or GED required.
Certificate 1 Certified Professional Coder required., or Certificate 2 Certified Coding Specialist required.
3-5 years related work experience required.
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Competencies:Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.
Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.
Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.
Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
Team Work: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.
Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally