About this role
Default Work Shift
Day (United States of America)
Hours
40
Salary range
$23.97 - $36.42
Schedule
Full Time
Shift Hours
8 Hour employee
Department
Clinic Billing Services
Job Objective
Reviews E&M and simple visit charges submitted by providers in assigned work queue(s) to validate level of service, place of service, new verses established, and modifier review to ensure valid creation of claim. Reviews and enters manual charges submitted by providers for external services. Reviews and resolves simple NCCI, LCD and MUE edits.
Job Description
Education
Required: High school diploma, GED or higher level degree
Preferred: Enrolled in a coding certification program or holding an Apprentice Certificate in coding- CPC or CCS; courses in Medical Terminology, Anatomy and Physiology
Licensure/Certification
Required: CPC-A, CPC, CSC or RHIT Coding Certification within eighteen (18) months of hire
Experience
Required: One (1) year of experience in billing/charge capture coding or related services
Reports To: Manager-Coding and Charge Capture
Supervises: N/A
Ages of Patients: N/A
Blood Borne Pathogens: Minimal/ No Potential
Skills, Knowledge, Abilities
Ability to use Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) and other relevant software applications, Coding software familiarity, Knowledge of Denial and appeals process, Knowledge of general CMS guidelines and general billing guidelines, Knowledge of ICD-10-CM & CPT/HCPCS coding conventions, Knowledge of medical terminology, anatomy and physiology, Written and verbal communication skills
Essential Responsibilities
- 1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
- 2. Maintains quality of work based on current published standards.
- 3. Reviews documentation and sequences diagnoses and procedures using current coding guidelines for E&M and simple visit encounters.
- 4. Completes claim information and validates for split or non-split payers.
- 5. Communicates with Coder IIs, department management and clinic staff to obtain needed documentation to ensure correct billing.
- 6. Completes assigned work queue assignments within departmental productivity standards.
- 7. Obtains and maintains a 95% accuracy rate.
- 8. Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient simple visit encounters.
- 9. Performs other duties as assigned.