Coder Certified

Job Description

Job Description

Description:

NO WEEKENDS, NO EVENINGS, NO HOLIDAYS

We offer competitive pay as well as PTO, Holiday pay, and comprehensive benefits package!

Benefits:

· Health insurance

· Dental insurance

· Vision insurance

· Life Insurance

· Pet Insurance

· Health savings account

· Paid sick time

· Paid time off

· Paid holidays

· Profit sharing

· Retirement plan 

GENERAL SUMMARY

The Coder Certified is responsible for successfully and efficiently coding all cases to the highest level of accuracy to ensure maximum reimbursement. The Coder Certified will ensure quality and productivity standards are met. The Coder Certified will ensure accurate coding of documentation to include diagnoses, procedures, and modifiers with adherence to established coding guidelines for both government and third-party payers. They work with the Coding Supervisor to escalate coding issues and prevent untimely claim submission and denials. 

ESSENTIAL JOB FUNCTION/COMPETENCIES

The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and/or state requirements. Responsibilities include but are not limited to:

• Reviews chart documentation for accuracy and completeness, identify inconsistencies in chart documentation, and work with appropriate staff and Coding Supervisor to resolve issues.
• Communicates with Claims Resolution Specialists and Business Office staff when necessary to resolve errors and clarify issues.
• Demonstrates and use in-depth knowledge of CPT, HCPCS, modifiers, diagnosis codes, insurance coverage plans, medical terminology, and anatomy and physiology.
• Works collaboratively with providers to obtain complete documentation to support coding.
• Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures.
• Identifies process opportunity trends and recommend ways to improve efficiencies.
• Responsible for maintaining current knowledge of coding guidelines and relevant state and federal regulations.
• Ensures adherence to third party and governmental regulations relating to coding, documentation, compliance, and reimbursement.
• Participates in special projects, personal development training, and cross training as instructed.
• Informs Coding Supervisor of trends, inconsistencies, discrepancies, or payer changes for immediate resolution.
• Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall.
• Performs other position related duties as assigned.
• Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training.

CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS

• CPC, CCS-P, CMRS or AAPC required.

KNOWLEDGE | SKILLS | ABILITIES

• Demonstrates an understanding of business operations and how individual actions contribute to overall performance.
• Excellent customer service, verbal, and written communication skills.
• Knowledge of medical terminology, CPT and ICD coding, and the full revenue cycle process.
• Familiarity with Electronic Health Record (EHR) systems and Microsoft Office applications.
• Understanding of Medicare, Medicaid, managed care, and third-party payer guidelines.
• Knowledge of governmental regulations and healthcare compliance requirements.
• Strong analytical and problem-solving skills with the ability to draw conclusions and make recommendations.
• Ability to handle multiple tasks and manage competing deadlines with a high level of accuracy and attention to detail.
• Capable of developing reports and creating professional presentations.
• Well-organized and able to maintain confidentiality in handling sensitive information.
• Self-motivated with a focus on maintaining productivity and efficiency.
• Ability to work independently and collaboratively across teams and departments.
• Ability to recognize coding issues and prevent untimely claim submission and denials.

EDUCATION REQUIREMENTS

• High School Diploma or equivalent required.

EXPERIENCE REQUIREMENTS

• At least 3 years experience to successfully perform this job.
• Entry level Medical Billing and Coding Terminology preferred.
• Experience in Urology or physician practice environment preferred.

REQUIRED TRAVEL

• N/A

PHYSICAL DEMANDS

Carrying Weight Frequency

1-25 lbs. Frequent from 34% to 66%

26-50 lbs. Occasionally from 2% to 33%

Pushing/Pulling Frequency

1-25 lbs. Seldom, up to 2%

100 + lbs. Seldom, up to 2%

Lifting - Height, Weight Frequency

Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%