Certified Professional Coder

Overview --------

A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements.

Responsibilities --------------

### Coding and Abstracting

• Accurately translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS).

### Documentation Review

• Analyze patient records for completeness, accuracy, and compliance with coding guidelines.

### Reimbursement Analysis

• Research and analyze data needs for accurate and timely reimbursement.

### Auditing and Compliance

• Conduct chart audits, identify coding discrepancies, and implement corrective actions.

### Communication and Collaboration

• Communicate effectively with healthcare providers to clarify coding issues and ensure accurate documentation.

### Staying Updated

• Keep abreast of changes in coding guidelines, regulations, and technology.

Qualifications ------------

### Education

• Certified Professional Coder (CPC) or Certified Coding Specialist Physician Based (CCS-P) or Certified Radiology Coder (RCC) is required.

### Experience

• Prior experience doing physician/provider professional fee billing is preferred.

### Skills and Abilities

• Coding Knowledge
• Strong understanding of coding systems (ICD-10, CPT, and HCPCS), coding guidelines, and relevant regulations.
• Attention to Detail
• Ability to meticulously review documentation and accurately assign codes.
• Communication Skills
• Effectively communicate with healthcare providers, billing staff, and other stakeholders.
• Problem Solving
• Ability to identify and resolve coding discrepancies and errors.
• Organizational Skills
• Maintain accurate records, manage workload effectively, and prioritize tasks.
• Computer Skills
• Proficiency in using coding software and electronic health records (EHR) systems.

Additional Requirements ----------------------

### Courier Route

• Must be able to use personal transportation to provide courier services for the office.

### DCH Standards

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Working Conditions -----------------

### Physical Presence

• Physical presence onsite is essential with possibility of hybrid work schedule.

### Physical Demands

• Medium work - Exerting 20 - 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to more objects.
• Physical Demand requirements are in excess of those for Light Work.
• Good manual and finger dexterity.
• Ability to tolerate prolonged periods of sitting.
• Some light driving required.

### Psychological Demands

• Contact with Others
• Deal with external customers/clients
• Sometimes dealing with unpleasant people
• Occasionally coordinating letters/memos
• Working with work groups or as a Team constantly/consistently.