Certified Professional Coder (CPC)
Maternal Fetal Medicine Practice
Job Summary
Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Accurately codes office and hospital procedures for providers to ensure proper reimbursement. Obtain prior authorizations. Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD-10-CDM, HCPCS and CPT codes.
Essential Duties
- Audits records to ensure proper submission of services prior to billing on pre-determined selected charges
- Receives hospital and office information to properly bill provider services for hospital consults, in-patient/out-patient services as well as office visit services and procedures
- Supplies correct ICD-10-CM diagnosis codes on all diagnoses provided
- Supplies correct HCPCS code on all procedures and services performed
- Supplies correct CPT code on all procedures and services performed
- Contacts providers to train and update them with correct coding information
- Attends seminars and in-services as required to remain current on coding issues
- Develops and maintains coding guidelines
- Audits medical records to ensure proper coding completed and to ensure compliance with federal and state regulatory bodies
- Accurately follows coding guidelines and legal requirements from to ensure compliance with federal and state regulatory bodies
- Maintains all mandatory in-services
- Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct. Reports compliance problems appropriately.
- Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.
- Quantitative analysis - Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
- Qualitative analysis - Evaluates the record for documentation consistency and adequacy Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
- Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code
- Performs other related duties, which may be inclusive, but not listed in the job description
Skills/Experience
- Knowledge of coding/billing practices and clinical procedures and policies
- Adherence to all company policies and HIPAA confidentiality
- Proficient in ICD-10 Microsoft Office, telephone and email communication
- Proficient in working within an Electronic Medical Records System (EMR)
- Ability to examine documents/records for accuracy and completeness
- Ability to work effectively with providers and all levels of the organization
- Minimum of one year of billing and coding experience in a health care organization/setting
- Auditing experience a must
One year of OB/GYN preferred but not required
Job Type: Full-time
Pay: $55,000.00 - $65,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Experience:
- ICD-10: 1 year (Preferred)
Work Location: In person
