Certified Medical Coder

RESPONSIBLE TO: Revenue Cycle Director

JOB SUMMARY: This position is responsible for ensuring all patient visits are entered into the Practice Management System with appropriate and accurate ICD-10 and CPT codes as well as any other codes that may apply. The Medical Billing Specialist will have frequent interactions with internal and external clients including Medical Office Staff and Providers. He/She will be the immediate liaison to documentation improvement and optimization for compliance and revenue purpose. Works closely with the A/R claims specialists to research and resolve reimbursement issues.

RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:

· Ensures accurate coding of services provided by AOA physicians and mid-level providers, including assigning the correct ICD-10 and CPT codes, modifier usage, and knowledge of CCI edits.

· Research difficult coding questions thoroughly in order to maintain high quality standards.

· Provides support to management, staff, and physicians in determining accurate coding and billing practices.

· Participates in coding audits and educational endeavors as directed by the Department Director.

· Stays up to date on all coding changes.

· Works closely with the Billing Lead/Accounts Receivable Lead to solve difficult claim coding related denials.

· Review, print, and distribute weekly Visit Tracking Logs ensuring appropriate follow up as necessary for appropriate and timely billing.

· Mentor and assist in the training of others within the department.

· Participate in the development of coding policies and procedures as identified.

· Notifies physicians of any surgical codes not received in a timely fashion.

· Attends regular staff meetings as requested.

· Maintains strict confidentiality.

· Performs any additional duties as assigned by the Supervisor or Manager.

EDUCATIONAL REQUIREMENTS:

• High School Diploma/GED or equivalent experience.

• College education or trade school preferred.

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or Certified Medical Coder (CMC) preferred.

• Experience with Orthopedic coding a plus.

QUALIFICATIONS AND EXPERIENCE

• Minimum 2 years’ experience working in a physician group practice billing department.

• Extensive knowledge of CPT, ICD-10 and HCPCS coding conventions.

• Appropriate knowledge of CMS guidelines and ability to apply accurately.

• Extensive knowledge of anatomy and physiology, medical terminology, disease processes and surgical techniques – including participation in continuing education programs.

• Computer literate, with keyboard skills-working knowledge of practice management software.

• Knowledge of third-party payer reimbursement guidelines.

• Ability to set priorities and meet deadlines without being micromanaged.

• Strong organizational skills.

• Neat, professional appearance.

• Strong written and verbal communication skills.