Job Description

CORE VALUE COMMITMENT:

In common mission, our teams work together with our patients at the center. We strive to continuously improve. We value one another’s diversity of talent, experience, and perspective. We each contribute to something bigger than ourselves while promoting integrity, belonging, and collaboration.

JOB SUMMARY:

The Clinical Coder is responsible for performing and ensuring the accurate and timely completion of patient record coding. This role serves as the educator, subject matter expert, and liaison for all coding matters. The Clinical Coder investigates and resolves coding related issues and leads the process improvement efforts to minimize inefficiencies, enhancing the patient experience.

ESSENTIAL JOB FUNCTIONS:

• Perform coding activities to assure accurate completion of coding for all patient records including review of each charge submission for accuracy, addition of appropriate modifiers, scrubbing of claims, preparation for insurance submission, and closing of clean batches.
• Analyze medical records for complete documentation and directly communicate with providers for clarification on any documentation that is incomplete or inaccurate.
• Remain current on all coding related regulations, standards, guidelines, industry trends, and Medicare announcements.
• Educate physicians, clinicians, and other healthcare staff on changes to coding policies, standards, regulations and advocate for proper documentation practices.
• Investigate and problem solve all contractual obligation (CO) denials received from the billing staff on charges reviewed and coded. Inform billing staff of the proper correction needed to reprocess the denied claims.
• Investigate and resolve all patient requests relating to the billing and coding of patient visits and subsequent bill received.
• Improve patient experience by being inquisitive, responsive, innovative, and flexible.

KNOWLEDGE, SKILLS & ABILITIES

• Knowledge of medical terminology, ICD-10, and CPT codes.
• Knowledge of Evaluation & Management coding.
• Knowledge of regulatory requirements related to coding.
• Skill in using a computer and a variety of software, including Electronics Health Records (EHR) software, Word, Excel, Access, and Outlook.
• Skill in communicating in a professional manner, both verbally and in writing.
• Ability to work independently and in a team environment.
• Ability to act as a good representative of the company.
• Ability to work flexible hours.

EDUCATION & EXPERIENCE:

Associate’s Degree in Medical Coding or equivalent experience required. Certified Procedure Coder (CPC) through National American Academy of Professional Coders (AAPC). Local involvement in AAPC and 2+ years of coding experience in a primary care setting preferred. Certified Risk Adjustment Coder (CRC) and prior medical coding audit experience preferred.

WORKING CONDITIONS AND PHYSICAL EFFORT:

This role operates in a healthcare setting. This position requires frequent sitting and computer work and allows employee to vary physical position or activity for comfort.

• Must be able to:
  • Stand 15% or longer of an 8-hour workday.
  • Walk 5% of an 8-hour workday.
  • Sit 80% of an 8-hour workday.
• Requires ability to lift up to 10 pounds occasionally.
• Requires employee to: bend, squat, kneel and reach above shoulder level occasionally and twist occasionally.
• Requires repetitive use of hands for: simple grasping, fine manipulation, computer use
• Requires all sensory skills (speech, vision, smell, touch, and hearing) corrected to near normal range.

NOTE: The information above is a reflection of the general nature of job duties. From time to time, additional duties may be assigned.

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