Job Overview
Job Description
Overview:
The Professional Physician Coder is responsible for effectively utilizing various physician billing and Health Information Systems in order to retrieve and compile essential records needed for precise coding and billing of professional physician and/or physician extender (mid-level) services. This position serves as an introductory level opportunity in the field of professional physician coding.
Responsibilities:
Evaluates patient medical documentation and applies up-to-date ICD-10, CPT, and HCPCS coding methodologies for physician services.
The International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), and Heath Care Financing Administration Common Procedure Coding Systems (HCPCS) are utilized for documenting diagnoses, coexisting conditions, adverse outcomes, medical interventions, tools, substances, injectables, and medications.
Works with the Central Business Office to guarantee thorough and proper tracking of patient accounts for optimal reimbursement outcomes, particularly in dealing with insurance denials.
Reports any breaches of compliance found during the review to the Team Lead, Manager, or Compliance division.
Effectively communicates with doctors, physician assistants, medical office staff, coding team members, and supervisor.
Utilizes the department's available resources to ensure coding practices are done accurately with support from resource materials.
Ensures the confidentiality of patients is upheld. Adheres to consistent and punctual attendance in alignment with the organization's guidelines and relevant federal, state, and local regulations, such as the ADA and FMLA.
Carries out additional tasks as required.
Qualifications:
EDUCATION:
Required:
Preferred:
EXPERIENCE:
Required:
Preferred:
LICENSURE/CERTIFICATION/REGISTRY/LISTING:REQUIRED
Required:
One of the following national certifications: Certified Professional Coder (CPC) through the American Academy of Professional Coders. CPC-A is a minimum requirement. Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA). Certified Coding Specialist-Physician (CCS-P) through the American Health Information Management Association (AHIMA). Certified Medical Coder (CMC) through Practice Management Institute.
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