What are the responsibilities and job description for the Certified Professional Coder position at Advanced Pain Care?
Job Description
Job Description
Description : Job purpose
The certified coder prepares and submits clean claims to insurance companies electronically and by paper, and provides appropriate coding for each patient’s medical history, diagnosis, tests and treatment plan.
Duties and responsibilities
Primarily codes from final office visit, surgical / procedural operative reports signed by providers
Reviews medical records and accurately code primary and secondary diagnoses using CPT, ICD-9 and ICD-10 conventions; sequence the diagnoses and procedures using coding guidelines
Verifies accuracy and submits claims to insurance using Electronic Medical Records systems and paper claims
Enters patient copayment information into the EMR
Reconciles charges against the schedule list to ensure no charges are missed
Investigates rejected claims to see why denials were issued as necessary
Re-bills rejected claims in timely manner
Maintains strict confidentiality and high degree of accuracy
Consults classification manuals and relies on knowledge of disease processes
Correlates information from supporting clinical documentation when appropriate
Communicates with clinical, ancillary services and medical personnel for needed documentation
Provides feedback to providers as it pertains to proper coding and clinical documentation
Keeps staff members informed of regulatory changes and updates
Identifies and participates in educational opportunities for self
Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements
Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
Operates standard office equipment (e.g. copier, personal computer, fax, etc.).
Has regular and predictable attendance
Adheres to Advanced Pain Care’s Policies and procedures
Performs other duties as assigned
Requirements : Qualifications
Education : Requires a high school diploma or GED; current CPC certification required
Experience : Prior medical coding experience required; must be familiar with correct billing techniques, CPT, ICD-9, ICD-10 coding, electronic medical records and strong knowledge of medical terminology.
Knowledge, Skills and Abilities :
Extensive knowledge of coding in-office and surgical procedures and applicable modifiers
Advanced knowledge of ICD-9-CM & CPT-4 coding conventions
Knowledge of Anatomy and Physiology
Knowledge of Medical Terminology
Knowledge of EMR systems and Microsoft software applications
Effective written and verbal communication skills
Data entry skills and ability to type 50 wpm
Proficient in using 10 key and doing basic arithmetic
Ability to maintain patient confidentially and comply with HIPAA guidelines
Time management skills and ability to work efficiently to complete tasks
Excellence in customer service
Working conditions
Environmental Conditions : Medical Office environment
Physical Conditions :
Must be able to work as scheduled – typically from 8 : 00 – 5 : 00 M-F
Must be able to sit and / or stand for prolonged periods of time
Must be able to bend, stoop and stretch
Must be able to lift and move boxes and other items weighing up to 30 pounds.
Requires eye-hand coordination and manual dexterity sufficient to operate office equipment, etc.
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