Surgical Coder/Charge Entry Sp

A busy multi-specialty practice is seeking an experienced and knowledgeable medical coder with specifically surgical coding experience.

GENERAL SUMMARY OF DUTIES:

The coder reviews, analyzes, and codes diagnostic and procedural information in the medical record that determines Medicare, Medicaid, and private insurance payments. The primary function of this position is to assign ICD10, CPT, and HCPCS coding based on provider documentation to ensure accurate reimbursement and tracking of services provided. The coding function ensures compliance with established coding guidelines, third party reimbursement policies, and regulations.

PRIMARY FUNCTIONS:

• Extracts pertinent information from patient medical records. Assigns ICD10, CPT/HCPCS codes and modifiers.
• Reviews and analyzes medical records to identify relevant diagnoses and procedures for distinct patient encounters.
• Translates/extracts diagnostic and procedural phrases into coded form - the accurate translation process requires understanding and interpretation of medical reports, industry standard and payer specific coding conventions and guidelines.
• Reviews denials for coding lapses and suggests coding changes for corrective and preventive action.
• Notifies a Manager or team lead when reports are incomplete and code assignments are not straightforward or documentation is incomplete.
• Keeps updates of coding guidelines, federal reimbursement requirements, and changes to third party reimbursement policies.
• Abides by Standards of ethical coding as set forth by American Academy of Professional Coders (AAPC} and American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Performs other related duties as required.

REQUIRED KNOWLEDGE, CERTIFICATION/ LICENSURE:

• Thorough understanding of the contents of surgical and hospital medical records in order to identify information to support coding.
• Thorough knowledge and experience in EHR and practice management systems, preferably Centricity.
• Basic knowledge of anatomy and physiology of human body and diseases in order to understand etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and procedures to be coded.
• Basic understanding of claims form and reimbursement process
• Understanding of local medical policies of carriers and Medicare.

• Education: High School degree or equivalent required; Associates preferred.
• Certification: CPC a plus.
• Experience: Minimum 3 years experience as a coder in a surgical physician group.
• Experience: Strong coding and reimbursement background.