CERTIFIED PROFESSIONAL CODER

Description

JOB SUMMARY: Responsible for accurate coding and billing of provider office, inpatient and outpatient charges to ensure coding and billing compliance is maintained. Maintains an extensive knowledge of CPT Procedural Coding, ICD-10 Diagnosis Coding and HCPCS Level II coding along with Evaluation and Management (E&M) documentation requirements.

DUTIES & RESPONSIBILITIES:

1. Responsible for reviewing and submitting charges from the coding workqueues (WQ).
2. Manually enters off-premise charges in Charge Review. If applicable, manually enters in-house charges for certain Specialty areas as designated. 
3. Ability to code for many different Specialties as assigned. Provides cross-coverage in the department as needed and directed by the Coding and Compliance Manager /Data Collection Team Leader.
4. If indicated, arrives the Surgery Schedule on a daily basis using the DAR function. Checks each patient in to create the visit number.
5. Reviews and processes re-submits.
6. Works closely with the Business Office staff. When able, assists the Business Office in certain areas as determined by the Business Office Director and Coding and Compliance Manager.  
7. Maintains, at a minimum, a 95% accuracy rate.
8. Maintains level of productivity as established for the department.
9. Provides education regarding proper E&M documentation of services, and coding education to new and existing providers as needed.
10. Researches and responds to coding questions from all providers, Administration, and Business Office staff.
11. Utilizes department coding reference material to assist with coding bundling edits, follow-up days, coding research, etc.
12. Assists with the development and recommends changes to policies and procedures to improve professional coding.
13. Upon identifying any coding, billing, documentation, and/or system issues, immediately notifies the Coding and Compliance Manager and/or Data Collection Team Leader. 
14. Assists with monthly pre-billing Evaluation and Management audits and Administrative reviews as needed.
15. Maintains working knowledge of CPT, ICD-10, HCPCS coding guidelines, governmental regulations, and third party requirements regarding coding and billing.
16. Attends meetings as requested.
17. Attends all required in-service programs and employee informational meetings as designated by Coding and Compliance Manager.
18. Practices time management, keeping authorized break periods within accepted policy. Maintains level of productivity as established for the department.
19. Works overtime when requested.

20. Complies with established SDMG attendance policy.

21. Complies with all SDMG policies and outlined in our Employee Handbook.

22. Provides proper notification for absences and scheduled time-off in accordance with SDMG policy.

23. Complies with SDMG Remote Coding policy and procedure.

24. Complies with SDMG policies and procedures pertaining to Incident Reporting and promptly notifies Coding and Compliance Manager and/or Data Collection Team Leader of all incidents.

25. Knowledgeable of individual responsibilities and duties pertaining to SDMG safety/emergency preparedness including emergency codes.

26. Demonstrates a knowledge of proper body mechanics to be used in the work setting.

27. May be exposed to hazardous drugs.  

28. Attends OSHA training upon initial employee orientation and annually completes an OSHA competency.

29. Assists with other duties as assigned by the Health Information Services Director/Data Collection Team Leader.

This is not a remote position; on-site only.

RELATIONSHIP WITH OTHERS: Must maintain a professional attitude with providers and clinical staff as well as staff and management in the Business Office at all times. Must exhibit a high degree of attention to detail, organization, and ability to work independently as well as part of a team

Requirements

EDUCATION/EXPERIENCE/KNOWLEDGE: Associates degree preferred. CPC or CCS-P credential required. In-depth knowledge of CPT, ICD-10, HCPCS Level II coding required. Possess knowledge of medical terminology and Evaluation and Management (E&M) documentation requirements. 3 years of multi-specialty coding experience preferred. Ability to use a computer, printer, mouse, calculator, copier, etc.  

Must maintain appropriate level of continuing education as required to maintain credentials.