Responsible for abstraction and accurate coding of procedures from various forms and medical records to ensure optimal reimbursement and compliance with all regulations, policies and procedures.
Abstracts and codes by Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) procedures and diagnosis from medical records.
Verifies medical record documentation requirements.
Responsible for verifying that CPT, Healthcare Common Procedural Coding System (HCPCS) & ICD coding used is correct.
Responsible for verifying that payment is correct for CPT, HCPCS & ICD coding.
Reviews charging procedures to ensure compliance with Federal regulations, and Medicare and Medicaid Policies.
Verifies correct interpretation was used in the calculation of write-offs.
Advises and educates faculty in regard to charge documentation, diagnosis, procedure coding, and charge policies.
Performs charge corrections.
Reviews patient admitting records and extracts relevant information.
Reviews source documents to determine if there is sufficient data to process.
Completes processing of all inpatient and outpatient documents. Assists with resolving department problems with patient billing.
May lead and train other Coders.
Performs various duties as needed to successfully fulfill the function of the position.
Qualifications - External Qualifications: Working Conditions:
Physical: Sit for prolonged periods. Communicate effectively and listens. Use of computer, calculator, and telephone.
Environmental: Standard office environment. Exposure to difficult customers and third party carriers over billing and coding issues.
Experience:
Required: 24 months experience with general coding
Education:
Required: High School Diploma or GED.
Certifications or Licenses:
Certified Professional Coder (CPC) or
Certified Outpatient Coder (COC) or
Certified Coding Specialist (CCS) or
Certified Coding Specialist - Physician based (CCS-P) or
National Healthcare Association Certification. (NHA).
Knowledge, Skills & Abilities:
Knowledge of CPT and ICD coding processes and determine which documentation is required to enter into the coding system
Knowledge of the different insurance carriers and their processes
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Excellent customer service
Ability to handle stressful situations in a professional manner
Ability to recognize a problem and solve in a timely manner
Talantage, LLC is committed to presenting candidates that contribute to an organizations culture of inclusivity and its commitment to diversity in the workplace are demonstrated through our recruitment practices. We are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, gender, gender identity, sexual orientation, marital status, national origin, citizenship status, disability, age, or veteran status. Our equal opportunity employment efforts comply with all applicable U.S. state and federal laws governing non-discrimination in employment.