What are the responsibilities and job description for the Surgery Coder position at Nimble Solutions?
Job Description
Job Description
Description : Company Overview
nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations who trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.
Job Overview
A Surgery Coder is responsible for reviewing and coding medical record related to surgical procedures in a healthcare setting. The primary goal is to ensure accurate and compliant billing for surgical services, using appropriate coding systems like the Current Procedural Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS). This role is essential for ensuring that healthcare providers receive proper reimbursement for services rendered and that billing is in line with regulatory standards.
Responsibilities
1. Review Medical Records
Review and analyze patient medical records, operative reports, and physician notes to determine the correct procedure codes
Ensure all relevant details of the surgical procedure, including diagnosis, surgical approach and complications are documented accurately
2. Code Surgical Procedures
Assign appropriate CPT, ICD-10, and HCPCs codes and modifiers for surgical procedures, diagnoses, and related services
Ensure codes reflect the complexity and scope of the procedure performed
3. Maintain Compliance
Adhere to all applicable guidelines and regulations, including those from the Centers for Medicare & Medicaid Services (CMS), the American Medical Association (AMA), and other relevant organizations
Ensure codes are compliant with federal, state, and payer-specific requirements
4. Audit and Accuracy
Perform periodic audits to check for coding errors, discrepancies, or potential issues
Verify coding accuracy to minimize claim denials and reduce the risk of audits from insurance companies or regulatory agencies
5. Billable Services
Ensure that all surgical services and related procedures are accurately billed for insurance purposes
Collaborate with billing and insurance departments to resolve any discrepancies or issues with submitted claims
6. Stay Updated
Continuously update knowledge of coding guidelines, including new codes, revisions, and changes in healthcare regulations
Participate in ongoing training and certification programs to maintain expertise in medical codin
7. Communication
Communicate with physicians, surgeons and other healthcare staff to clarify any ambiguities in medical records or documentation
Address coding inquiries from healthcare providers or insurance companies
Requirements :
Certification : CPC (Certified Professional Coder) through AAPC, CCS (Certified Coding Specialist) through AHIMA, or a similar credential from a recognized coding body
Experience : Two years minimum surgery coding experience
Knowledge of Medical Terminology : Strong understanding of medical terms, anatomy, and surgical procedures
Attention to Detail : High level of accuracy when reviewing and assigning codes to ensure proper billing and compliance
Computer proficiency : Familiarity with electronic health record (EHR) systems and coding software
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