The Certified Professional Coder is responsible for coding diagnosis and procedures from medical records for the purpose of reimbursement, research and compliance with regulations. Ensures billing procedures are per Central Billing Office standards.
Essential Job Functions:
1. Obtains patients information from providers regarding services for hospitalized patients.
2. Utilizes history and physicals, operational logs, nursing notes, and discharge summaries to generate accurate CPT, HCPCS and ICD-9CM codes.
3. Confirm information and return encounters to resident for correction for optimum reimbursement.
4. Maintains monthly lag report for program director.
5. Provides timely and accurate practice statistics on procedures productivity.
6. Participates in educational programs and in-service meetings.
7. Actively participates in Continuous Quality Improvement.
8. Creates and provides physician and advance practitioners with training packets regarding E&M, surgical, radiology, and laboratory and medicine services.
9. Trains and updates physicians on coding techniques and usage of hospital and practice super bill.
10. Maintains and promotes patient confidentiality by following current HIPAA guidelines.
11. Maintains open lines of communication with Physician(s), Nurse(s), Administration, Billing Management and other departmental personnel.
12. Provides and enters correct and complete registration for inpatients.
15. Remind providers to complete and submit their billings in a timely manner so that charges are submitted in a timely manner.
16. Consistent in entering charges as received throughout the month.
17. Audits all other charts as needed.
18. Utilizes personal protection equipment (PPE) per facility standards.
19. Demonstrates ability to assess a situation, consider alternatives and choose an appropriate course of action.
20. Communicates with physician education and compliance department, at corporate headquarters, when necessary to answer complex coding or physician questions.
21. Available and willing to work some evenings and weekends to be able to get charges in by month end. Also understands that requests for time off at month end, may be denied without adequate coverage.
22. Performs other related duties as assigned or requested.
Level 1 - Coder has demonstrated competence in the appropriate assignment of ICD, CPT, and HCPCS codes for outpatient ancillary patient types. This may include, patient services such as: lab, rad, tests, inpatient and outpatient procedures.