Essential Duties & Responsibilities:

Coding & Data Entry

·        Reviews current state and federal coding and billing requirements and regulations.

·        Analyzes each encounter to ensure proper diagnosis and required information are present to appropriately code for maximum reimbursement.

·        Analyzes each encounter to assign and sequence a variety of codes including but not limited to ICD/CPT/HCPCS codes to achieve maximum reimbursement.

·        Ensures claims are coded in compliance with state and federal regulatory requirements.

·        Provides documentation and coding training to improve provider inconsistencies, discrepancies and/or trends within the medical record.

·        Performs qualitative analysis by evaluating the record for documentation consistency and adequacy.  Ensures that the final diagnosis accurately reflects the care and treatment rendered.  

·        Provides ongoing education, updates and briefings for medical staff, business office staff, and other health care providers on changing coding conventions, rules, regulations, and guidelines.

·        Assists in the development and modification of organizations coding policies and procedures.

·        Data enters diagnosis, procedures, treatments, measurements panels, lab results, problem lists, patient education, past medical and surgical history and cause and place of injury.

·        Enters statistical information on clinic services, provider services, arrival times, location of visit, and level of patient services.

·        Data enters assigned ICD/CPT/HCPCS codes.

·        Prepares reports concerning Coding and Data entry to the Business Office Manager.

·        Reconciles billing from lab provider.

·        Reviews error report on PCC open entries and makes necessary data entry to clear errors.

·        Responsible of daily cash box for collections of co-pays, deductibles, and private pay payments.

·        Batches and reconciles payments received by patients.

Physical Demands:

While performing the duties of this job, the employee regularly is required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear.  The employee frequently is required to walk.  The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl.  The employee must occasionally lift and/or move up to 25 pounds.

Work Environment:

Work is generally performed in an office setting with a moderate noise level.

Knowledge, Abilities, Skills, and Certifications:

·        Knowledge of modern office practices, procedures, and equipment.

·        Knowledge of business English, proper spelling, grammar, punctuation, and basic arithmetic.

·        Knowledge of records management and basic accounting procedures.

·        Knowledge and comprehension of medical terminology. 

·        Knowledge of modern clinical office practices and procedures. 

·        Knowledge of Insurance Billing and proper usage of CPT and ICD9 coding.

·        Ability to communicate effectively in the English language both verbally and in writing.

·        Ability to establish and maintain professional relationships with individuals of varying social and cultural backgrounds and with co-workers at all levels.

·        Ability to represent the organization in a professional manner, building respect and confidence.

·        Ability to maintain confidentiality.

·        Ability to handle multiple tasks and meet deadlines.

·        Ability to carry out instructions furnished in verbal or written format.

·        Ability to work independently with minimal supervision.

·        Ability to demonstrate excellence in everything, and continually seek improvement in results.

·        Skill in operating business computers and office machines, including in a Windows environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).