Job Title: Medical Coder
Reports to: Division Director of Medical Billing
Position Summary: The Coder is responsible for a variety of technical functions that requires critical thinking and problem solving skills. The coder is responsible for providing coding services for multiple locations and multiple specialties.
- Assigns CPT procedure codes for clinician services to assure appropriate billing and reimbursement.
- Assigns diagnostic (ICD-9-CM and/or procedural codes (ICD-9-CM & CPT) on all medical record types at an advanced level to ensure proper reimbursement and accurate data base information.
- Assigns modifiers to codes.
- Input charges for all urgent care , clinic and inpatient centers on a daily basis.
- Obtain insurance referrals and verify insurance coverage on a daily basis.
- File claims to the appropriate insurance company on a daily basis.
- Post all copayments and self pay payments and reconcile on a daily basis.
- Send refunds to both patient and insurance carrier if there is an overpayment.
- Reviews charts and provides one-to-one and group educational feedback to the clinicians.
- Interacts with clinician and other clinic/corporate departments to assure compliance and appropriate billing practices.
- Gather data and prepare information/reports as requested by Division Director of Medical Billing.
- Handle billing correspondence.
- Maintains confidentiality in all aspects of the job.
- Performs other related duties as assigned.
- Completion of accredited coding program (Certified Coding Specialist or Certified Professional Coder)
- Certified coder through AHIMA, AAPC, PMI or equivale
- Minimum of Bachelor’s degree from an accredited university or college experience can be in lieu of degree.
- Minimum 3 years specialty billing/coding in the area of internal medicine, family medicine and/ or emergency medicine.
- Ability/knowledge to code multiple specialties.
- Worker's Comp. experience preferred.
- Knowledge of patient insurances. Ability to provide instruction to the patients and their families regarding insurance coverage procedures.
- Ability to perform standard office procedures according to established protocols.
Knowledge, Skills & Abilities:
- Experienced and comfortable providing education to providers one on one and in group setting on a frequent basis and work with the providers to optimize their billing.
- Knowledge of and ability to use computer systems and other office equipment.
- PC skills, with emphasis on Windows applications, and ability to use a mouse.
- Keyboarding/data entry skills.
- Ability to perform detail-oriented work.
- Thorough knowledge of medical terminology, anatomy, physiology and disease process.
- Ability to work independently yet in conjunction with a team.
- Ability to adapt to a changing and growing atmosphere.
- Good time management and organizational skills.
- Knowledge of medical reimbursement methodologies.
- Ability to speak in a group setting. Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form.
- Courteous and professional demeanor.
- Willingness to work as a team player to meet common goals of the department.
- Demonstrates excellent verbal and written communication skills.
- Ability to work under pressure and meet deadlines.
- Excellent customer service skills.
- Ability to maintain a professional demeanor and composure when handling difficult clients/stressful situations.
- Promote positive department morale through effective teamwork.
- The employee must have the ability to work overtime hours when necessary.
- Willingness to learn new skills and help in different areas.
- Ability to work and travel to multiple locations.
- Ability to stand, walk, or sit for an extended period of time. Reaching by extending hand(s) or arm(s) in any direction. Finger dexterity required manipulating objects with fingers rather than whole hand(s) or arm(s).
- Excellent written and verbal communication skills.
- Ability to see within normal parameters.
- Ability to hear within normal range.
- Ability to stoop, bend, push or lift 50 pounds.