Coder (CPC or CCS) - Health Information - Full Time

Job Description

Position Title: Professional Services Certified Coding Reviewer

Department: Health Information Management Safety Sensitive: YES

Reports to: HIM Director/Manager Exempt Status: NO

Position Purpose

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision of providing the region’s best clinical care and patient service through an environment that fosters respect for others and pride in performance.

Key Responsibilities

· Provides excellent customer service and adheres to the KRMC Behavioral Expectations Agreement.

· Ensures data quality and compliance with State, Federal and regulatory requirements

· Evaluates medical record documentation and charge tickets to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits.

· Manage work activities, work assignments and schedules to ensure accurate and timely submission of information.

· Provides technical guidance and training, when instructed, to physicians and their office staff on proper code selection and documentation to improve skills in the collection and coding quality health data.

· Provides on-going education for coding department staff, physicians, business office and other ancillary departments on both general and specific coding issues.

· Perform coding audits and reviews for practices and providers.

· Evaluate and report audit results and findings.

· Review bulletins, newsletters and periodicals and attends workshops to stay abreast of current issues, trends and changes in the laws and regulations governing medical record coding and documentation.

· Review Business Office adjustment request as submitted and follow process as documented by the Business Office Manager

· Evaluate insurance requests/claim denials to assist with the revenue cycle.

· Provides reports as requested on data collected, abstracted and coded.

· Performs charge audits in a timely and accurately manner.

· Report findings effectively, conduct training for physician and/or the physician’s staff when appointed, including training material as needed to support audit results.

· Proves knowledgeable in and correctly utilizes ICD-9 (10), CPT, HCPCS and all other resources available to ensure proper coding and billing per CMS billing guidelines.

· Demonstrates dependability, teamwork, and maintains patient confidentiality.

· Develops and maintains excellent relationships with providers, provider’s staff, operational directors, and business office staff.

· Works well with individual practices, the Business Office, and Operation Directors.

· Performs and communicates in a highly professional manner at all times.

· Completes assignment and projects timely, as directed.

· Demonstrates enthusiasm and self-motivation in performing job duties

· Strives to be a productive member of this institution, attends departmental meetings as required, maintains certification, and obtains continued education units (CEU).

· Completes all other duties, projects, and assignments as directed/requested.

Required Qualifications

• Advanced knowledge of ICD-9-CM, ICD-10-CM, CPT, HCPCS, Medical Terminology and medically approved abbreviations required.
• Thorough understanding of CMS coding and billing guidelines required.
• Excellent written and verbal communication skills and critical thinking skills.
• Ability to work independently and make independent decisions based on specialized knowledge.
• Computer literacy and familiarity with the operation of basic office equipment.
• Maintain high standard of work performance, remaining professional, responsive and cooperative with physicians, their office staff and fellow co-workers.

Education: High school diploma or equivalent

Certification/Licensure: Maintains current Certified Coding Specialist (CCS) issued by the American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) issued by the American Academy of Professional Coders (AAPC).

Experience: Minimum of 2 years’ experience in a medical billing/coding office.

Preferences [Preferred attributes for the position which are not absolutely required in the minimum qualifications (i.e., multi-lingual, master’s degree)]

Special Position Requirements [Optional section: any travel, security, risk, hazard or related special conditions which apply to the position]

· Travel to off-site locations as required.

Exposure Categories: Category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids or tissues

Work Requirements [Optional section: work requirements for physical or other important issues which relate to the job]

· Ability to stand and walk in the performance of job responsibilities.

· Ability to work at a computer for extended periods.

· Some bending and lifting may be required.

Date Staff Position Description Created / Revised: 03/07/2019

Posting Date: 2025-02-18T18:39:10 00:00

Locations: 3269 Stockton Hill Road Kingman AZ 86409