Medical Coder

Education and Experience:

Graduation from a formal coder training program or completion of an academic class in medical coding.

2+ years of hospital coding or charge audit experience.

2+ years of coding experience may substitute for educational requirements

HS Diploma (or equivalent – GED) is a MUST

Additional Qualifications:

-Coding Knowledge and Skills:

Proficiency with ICD-10-CM/PCS, CPT-4, and HCPCS code sets/systems.

Experience with electronic medical billing systems such as PBAR and Cerner.

Understanding of federal coding compliance regulations and guidelines.

-Accuracy and Productivity:

Ability to meet productivity and accuracy/quality standards, including entering 98% of CCL charges into the electronic billing system within 3 days of the date of service.

Collaborative Skills:

Experience working collaboratively with physicians, staff, and management to identify opportunities for improving charge capture and billing accuracy.

Error Resolution and Process Improvement:

Capability to review, reconcile, and correct charges and documentation errors.

Ability to provide recommendations for staff education and process improvements to the CCL Manager.

Nice-to-Haves:

Technical Proficiency:

Familiarity with Soarian Financials Billing Edits and Billing Processes.

Additional Skills:

Experience in reviewing and editing previously submitted charges due to billing errors or insurance requirement changes.

Ability to consult with medical providers to clarify record information and determine appropriate codes.

Additional Experience:

Experience in reviewing and reconciling charges in other electronic medical billing systems beyond PBAR and Cerner.

Experience with cardiac Cath lab procedures and charges.

Responsibilities:

In accordance with current federal coding compliance regulations and guidelines, use current ICD-10-CM/PCS, CPT-4, and HCPCS code sets/systems to accurately abstract, reconcile and review procedure and physician documentation in order to code, and enter into PBAR, Cerner or other electronic medical billing systems.

Understands coding/billing computer systems in a manner to assure bills drop timely with appropriate codes.

Meet the productivity and accuracy/quality standards including, but not limited to 98% of CCL charges entered into the electronic medical billing system within 3 days of date of service.

Work collaboratively with physicians, staff and management to identify opportunities for improving charge capture, accuracy and timeliness of entry into electronic billing systems.

Recommendations for staff education and process improvement will be escalated to the CCL Manager.

Primary Accountabilities:

Support Soarian Financials Billing Edits and Billing Processes

Reviews and reconciles procedure documentation with supply charges and physician documentation

Partner with staff and physicians to correct inaccuracies in HCPCS, ICD-10, CPT coding to accurately capture services provided

Enters Cardiac Cath Lab procedure and supply charges into electronic billing systems (PBAR)

Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate review of ICD10 and/or CPT code assignments with physician.

Reviews, reconciles and corrects Cardiac Cath Lab charges in Cerner

Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes.

Provides completed patient data to billing staff or designated personnel.

Performs other duties as assigned.

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**

Benefits:

For information and details on employment benefits offered with this position, please visit

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California Pay Equity:

For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website

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Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.

If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise,

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Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).