CERTIFIED PROCEDURAL CODING SPECIALIST

Description

Certified Procedural Coding Specialist

Galen Medical Group offers several medical specialties throughout the Chattanooga region. We provide quality care and patient-friendly services to adults and children of all ages. Our mission is to elevate the health of our community through multiple medical specialties providing excellent care delivered with wisdom, compassion, integrity and a commitment to technology, education, and scientific inquiry. We are seeking qualified, like-minded applicants to join our team!

Office Hours  Monday thru Friday  8:00AM - 5:00PM

The Certified Procedural Coding Specialist efficiently and accurately monitors the coding practices of the organization and educates providers and employees of appropriate coding practices, as outlined in regulations.

RESPONSIBILITIES:

• Verifies data in the medical chart for completeness and accuracy in regards to appropriate coding regulations and ethics.
• Reviews insurance explanation of benefits for procedures to ensure appropriate reimbursement.
• Monitors reimbursement of selected procedures on a continual basis.
• Codes questionable or new services and reviews with those individuals involved in the services.
• Perform minimally annual targeted and random audits of patients charts for appropriate charges and diagnosis codes at the individual sites. These written reports of findings are to be used to 1) educate providers, 2) document and 3) comply with corporate compliance.
• Meet with providers, regional managers and other site coders regarding coding practices.
• Attend appropriate seminars and meetings regarding coding education and practices.
• Conduct coding workshops for clinical support and providers at the site location.
• Oversee coding reviews with providers at the site location.
• Assist with the development and continuous monitoring of a coding compliance program for the corporation while maintaining records of surveys and coding errors and corrections.
• May assist Billing Department in conducting annual fee survey to compare fees with codes.
• May assist the Billing Department in maintaining reimbursement profiles from third parties and compare with groups fees.
• Files medical records in designated areas according to applicable alphabetic and numeric filing system after reviewing the chart for auditing purposes.
• Review and maintain on a continual basis all bulletins and correspondence from carriers for up to date information.
• Operates computer to enter and retrieve data and type correspondence and reports.
• Make recommendations for any improvements in the operation of the medical records or coding department.
• Contributes to team effort by accomplishing related results as needed.
• Assist other personnel in the performance of their duties as assigned and as workload permits.
• Function as relief for other personnel in the office as appropriate and to facilitate co-workers absence in the office.
• Recognize and demonstrate cost-effective measures in the utilization of supplies and equipment.
• Maintain the strictest confidentiality of all company records, including verbal and written records.
• Other duties as assigned by Regional or Site Manager.

KNOWLEDGE/EXPECTATIONS:

• Promote the mission, vision, and values of Galen Medical Group.
• Maintain confidentiality of all patient, medical, financial, and legal information.
• Report to work on time and as scheduled.
• Wear identification during work hours.
• Represent the organization in a positive & professional manner.
• Ability to handle difficult situations involving patients, physicians, or others in a professional manner.
• Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude.
• Comply with all organization policies and standards regarding ethical business practices.
• Participate in performance improvement and continuous quality improvement activities.
• Attend regular staff meetings and in-services as directed by your manager.
• Consistently demonstrate the value of a team concept.
• Ability to manage multiple and simultaneous responsibilities.
• Complete assignments efficiently and in a timely manner.
• Understands and abides by OSHA, HIPAA & CLIA standards.

WORKING HOURS:

1. Work hours can be PRN, Pro-rated FT or FT based on needs of the site.

2. Weekends, holidays and overtime must be worked as required by department.

3. Galen reserves the right to change the work schedule of any employee when it is considered in the best interest of the organization.

4. The reasonable scheduling of overtime is the prerogative of Galen, and employees will be expected to work such overtime unless excused by their supervisor.

The above job description is intended to describe the general content of and requirements for this job. It is not intended to be a complete statement of duties, responsibilities or requirements.

Qualifications

QUALIFICATIONS:

Education:

• High school graduate or equivalent

Experience:

1. High school graduate or equivalent.
2. Prefer individual with two to three years medical experience.
3. Medical experience and terminology required.
4. Must be computer literate.
5. Must be a certified procedural coder and maintain certification throughout employment.
6. Must have strong analytical, oral and written communication skills

• Must be a certified procedural coder and maintain certification throughout employment.
• Must have strong analytical, oral, and written communication skills.
• Must be computer literate.

As part of the Galen Medical Group, the applicant must be a team player and provide excellent customer service while assessing our patients needs efficiently. Perform all duties in compliance with Galen Medical policies, HIPAA and OSHA standards.

Galen Medical Group is a member of the TN Drug-Free Workplace and it is a requirement that we conduct a pre-employment drug screen, as part of the hiring process.

Why should you apply?

• 401(k) benefits.
• Education reimbursement.
• Holiday Pay.
• Great earned time-off policy.
• Company-paid Life Insurance & Long Term Disability.