Description

JOB SUMMARY: Responsible for accurate coding and billing of provider office, inpatient and outpatient charges to ensure coding and billing compliance is maintained. Maintains an extensive knowledge of CPT Procedural Coding, ICD-10 Diagnosis Coding and HCPCS Level II coding along with Evaluation and Management (E&M) documentation requirements.

Duties & Responsibilities

• Responsible for reviewing and submitting charges from the coding workqueues (WQ).
• Manually enters off-premise charges in Charge Review. If applicable, manually enters in-house charges for certain Specialty areas as designated.
• Ability to code for many different Specialties as assigned. Provides cross-coverage in the department as needed and directed by the Coding and Compliance Manager /Data Collection Team Leader.
• If indicated, arrives the Surgery Schedule on a daily basis using the DAR function. Checks each patient in to create the visit number.
• Reviews and processes re-submits.
• Works closely with the Business Office staff. When able, assists the Business Office in certain areas as determined by the Business Office Director and Coding and Compliance Manager.
• Maintains, at a minimum, a 95% accuracy rate.
• Maintains level of productivity as established for the department.
• Provides education regarding proper E&M documentation of services, and coding education to new and existing providers as needed.
• Researches and responds to coding questions from all providers, Administration, and Business Office staff.
• Utilizes department coding reference material to assist with coding bundling edits, follow-up days, coding research, etc.
• Assists with the development and recommends changes to policies and procedures to improve professional coding.
• Upon identifying any coding, billing, documentation, and/or system issues, immediately notifies the Coding and Compliance Manager and/or Data Collection Team Leader.
• Assists with monthly pre-billing Evaluation and Management audits and Administrative reviews as needed.
• Maintains working knowledge of CPT, ICD-10, HCPCS coding guidelines, governmental regulations, and third party requirements regarding coding and billing.
• Attends meetings as requested.
• Attends all required in-service programs and employee informational meetings as designated by Coding and Compliance Manager.
• Practices time management, keeping authorized break periods within accepted policy. Maintains level of productivity as established for the department.
• Works overtime when requested.
• Complies with established SDMG attendance policy.
• Complies with all SDMG policies and outlined in our Employee Handbook.
• Provides proper notification for absences and scheduled time-off in accordance with SDMG policy.
• Complies with SDMG Remote Coding policy and procedure.
• Complies with SDMG policies and procedures pertaining to Incident Reporting and promptly notifies Coding and Compliance Manager and/or Data Collection Team Leader of all incidents.
• Knowledgeable of individual responsibilities and duties pertaining to SDMG safety/emergency preparedness including emergency codes.
• Demonstrates a knowledge of proper body mechanics to be used in the work setting.
• May be exposed to hazardous drugs.
• Attends OSHA training upon initial employee orientation and annually completes an OSHA competency.
• Assists with other duties as assigned by the Health Information Services Director/Data Collection Team Leader.
  
  

This is not a remote position; on-site only.

RELATIONSHIP WITH OTHERS: Must maintain a professional attitude with providers and clinical staff as well as staff and management in the Business Office at all times. Must exhibit a high degree of attention to detail, organization, and ability to work independently as well as part of a team

Requirements

EDUCATION/EXPERIENCE/KNOWLEDGE: Associates degree preferred. CPC or CCS-P credential required. In-depth knowledge of CPT, ICD-10, HCPCS Level II coding required. Possess knowledge of medical terminology and Evaluation and Management (E&M) documentation requirements. 3 years of multi-specialty coding experience preferred. Ability to use a computer, printer, mouse, calculator, copier, etc.

Must maintain appropriate level of continuing education as required to maintain credentials.