Coder I

Description:

The Coder I is responsible to lead our billing team to obtain accurate reimbursement for our providers’ claims. This is done through thoroughly reviewing, analyzing, and coding both diagnostic and procedural documentation used in the billing of charges for physician services.

Responsibilities:

• Performs initial charge review to determine appropriate CPT and ICD-10 codes to be used in reporting physician services to third party payers.
• Interprets progress notes, operative reports, and charge documents to determine services provided and accurately assigns CPT and ICD-10 codes to these services. Provides coding education to client as required.
• Performs a comprehensive review of the record to assure all vital information such as patient identification, signatures, and dates are all present in the record.
• Evaluates the records for documentation consistency and adequacy. Ensures that the diagnosis(es) accurately reflects the care and treatment rendered.
• Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
• Analyze provider documentation to confirm the appropriate Evaluation & Management levels are assigned using the correct CPT codes.
• Responsible for ensuring the batch processes for all coded charges.
• Utilizes batch-logging systems to comply with internal audit standards.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Maintains comprehensive knowledge and understanding of changing guidelines and regulations to ensure the practice is compliant.
• Demonstrates high productivity using the RCM Benchmarks.
• Consistently meets and/or exceeds 90% on monthly internal audits.
• Attend and participate in internal and client meetings.
• Research and/or write at least 1 article per calendar year for MMG LinkedIn Blog on a coding-related topic.
• Abide by HIPPA standards and requirements.
• Performs other related duties as required and assigned.

Qualifications:

• High school diploma or equivalent.
• Certified professional coder through AAPC is required with a minimum of two years’ experience with CPT and ICD-10 coding is preferred.
• Experience with Urology, Behavioral Health, FQHC's, Hospital Surgical highly desired.
• Experience with Auditing and Education Training also highly desired.
• Responsible for maintaining continuing education per certification requirements.
• Clear understanding of protocols and procedures in a medical office including health information management, confidentiality, and safety.
• Follows policies and procedures pertinent to the coding and compliance departments.
• Organize and prioritize responsibilities while remaining flexible to changing demands.
• Excellent written and oral communication skills, with the ability to interact with clients, coworkers, and others.
• Strong analytical skills and attention to detail.
• Must have high level of discretion and judgment.
• High proficiency with computer software including but not limited to health information management system, billing software, insurance websites, and Microsoft Office.
• Maintain a strong working relationship with the providers and management team.
• Work in collaboration with other staff to maintain a team-oriented environment.
• Ability to multi-task.

Physical Demands:

• Work may require sitting for long periods of time.
• Occasionally lifting files or paper.
• Operating a computer, keyboard, a calculator, telephone, copier, fax, scanner, or other such office equipment through a normal business day.
• Vision must be correctable to 20/20 for viewing information on computer screen and reading information in a paper format.
• Hearing must be in the normal range for telephone contacts.
• Will require viewing computer screen and typing on a keyboard for prolonged periods of time.

This job description is intended to provide a basic guideline for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change, as necessary.