We are currently seeking Certified Medical Coders who will be responsible for accurately assigning diagnosis and procedural codes and modifiers for physician inpatient and outpatient multi-specialty surgeries.
The Certified Medical Coder (Coder) assigns diagnosis and procedural codes and modifiers for physician inpatient and outpatient surgical cases. The Coder also verifies and audits physician-completed charge tickets by ensuring accuracy of code assignment and completeness or required billing data elements prior to tickets being processed for payment and revenue reporting. The Coder must apply all appropriate coding guidelines and criteria for code assignment
Reviews and examines entire current operative report for accurate and complete diagnostic and procedure information. May be required to request diagnosis or other data from physicians when not recorded in operative report, or if information is incomplete.
Understands and implements coding guidelines for multi-specialty surgical practices and/or complex surgical codings.
Determines correct sequence of primary and secondary diagnoses according to uniform surgery procedure data guidelines.
Abstracts all surgical and designated diagnostic procedures and assigns appropriate procedure codes and modifiers using the International Classification of Diseases (ICD-9) system, and the Physicians’ Current Procedural Terminology (CPT-4).
Applies knowledge of ICD-9-CM, CPT-4, HCPCS, and modifiers to all physician coding and billing assignments.
Answers coding questions from staff and identifies and corrects errors as needed.
Interacts with physicians and peers face-to-face, by telephone, and in writing in a professional and productive manner.
Maintains and expands knowledge of Anatomy and Physiology, Pathophysiology, Pharmacology, and Medical Terminology as basic building blocks for ICD-10-CM coding.
Stays current on coding and compliance regulatory requirements through professional membership literature, continuing education classes, support and networking groups
Maintains current knowledge of regulatory requirements by CMS NCCI and MUE edits, Medi-Cal/CCS policies, and certain Medicare requirements
Attends various meetings and professional development programs on a regular basis; makes recommendations for revisions and/or new departmental procedures under the direction of the supervisor.
Analyzes and evaluates data with reference to standards and considers alternatives.
Attends in-services related to coding problems.
Performs other related duties as assigned.
Qualifications Education and Experience:
High school graduate or equivalent.
Credential/certification from the American Academy of Professional Coders (CPC) or American Health Information Management Association (CCS, CCS-P, RHIT, RHIA)
Minimum Five (5) years coding multi-specialty Physician Surgical
Thorough knowledge of medical terminology, anatomy and physiology, pharmacology.
Proficient in Microsoft Office applications (Word, Excel)
Typing ability of at least 50 wpm.
Knowledge, Skill & Ability:
Knowledge of medical records coding procedures.
Knowledge of medical terminology, CPT and ICD-9 coding, Medicare, Medi-Cal/CCS, and other insurance procedures.
Experience in medical practice/physician setting with exposure to claims procedures.
Ability to meet deadlines and to follow assignments through to completion.
Ability to communicate on a professional level using good grammar, correct spelling, and courteous communications.
Skill in establishing and maintaining effective working relationships with physicians and peers. Must be detail oriented with the ability to work independently and/or minimal supervision with further abilities to manage multiple, changing priorities.
Must maintain confidentiality pursuant to HIPAA and the HITECH Act regulations.
Ability to prepare, file and maintain patient records, files reports, and other correspondence.
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