POSITION SUMMARY: Under the general supervision of the Lead CPC , the Certified Professional Coder reviews the patient health record documentation and assures assignment of correct diagnosis and procedure codes which will be used for billing and reimbursement purposes.
ESSENTIAL JOB FUNCTIONS: Essential functions, as defined under the Americans with Disabilities Act, may include any of the following tasks, knowledge, skills, and other characteristics. The list that follows is not intended as a comprehensive list, but rather to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed, and may be required to perform additional supportive tasks.
1. Abstracts all necessary information from clinical notes to ensure proper coding and reimbursement.
2. Performs a comprehensive review for the record to ensure the presence of all component parts such as: Patient and records identifications, signatures and dates where required and any other necessary data.
3. Reviews the records for compliance with established third party reimbursement agencies.
4. Have a working knowledge of Insurance guidelines including Medicare and Medi-cal.
5. Work with physicians and medical staff to ensure patient visits are documented and completed within NVIH current Policy.
6. Collect and report data as necessary and required by related agencies.
7. Maintain security and accuracy of patient data base.
8. Coordinate with other key personnel in facilitating any coding issues or concerns
9. Meets all monthly coding deadlines in order to billing to be completed on a timely basis.
10. Participates in Coding meetings as-needed. Participates in the implementation of Corrective Action Plans for addressing any coding audit findings.
11. Data entry duties.
1. Process prior authorization requests.
2. Manage referral tracking follow-up and reports.
3. Perform scanning duties.
4. Other duties as assigned.