Certified Professional Coder

Seeking an experienced certified professional coder (CPC) who would be responsible for correctly coding healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs such as Medicare. The CPC candidate must also dually function as a medical auditor. As a medical auditor the prime responsibility is to plan and conduct financial chart audits present audit results to senior management and provide coding/documentation/compliance support to the Account Management team. The candidate must strive to deliver the highest of customer service standards. This position works collaboratively with the Account Management team in accordance with established billing and collections policies and procedures running all standard monthly reports and performing followup with insurance tracking report as directed.

This position is full time and in office only. Remote / hybrid working is not currently an option

Qualifications :

• Preferred 5 years experience in a medical office reimbursement department
• Certified and have a current AAPC membership and maintain certification requirements every 2 years
• Strong communication skills as you will be speaking with insurance representatives medical billing staff and/or Account Management team on a weekly basis
• Advanced ICD10 and CPT coding anatomy and medical terminology knowledge required.
• Must maintain HIPAA standards
• Must have knowledge medical record audit process
• Ability to work in a fastpaced environment while remaining calm and professional
• Strong customer service orientation
• Excellent organizational skills and must be detailed oriented
• Proficiency in Microsoft Office
• Strong computer and typing skills
• Positive friendly approachable disposition
• Ability to work with multiple priorities
• Must have the ability to work independently

Additional Information :

POSITION DESCRIPTION (ESSENTIAL FUNCTIONS)

• Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing.
• Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. If a claim is denied due to incorrect coding the coding specialist conducts medical records research and corresponds with insurance companies and Account Management team to resolve the issue.
• Perform internal retrospective concurrent or prospective medical chart audits to assure that CPT codes billed are appropriate and supported by documentation in the patient record and that all coding/documentation combinations are compliant with Federal and State regulations.
• Medical coding used is in compliance with all medical coding laws and regulations and ensure that the coding used is for reimbursable expenses when necessary
• Protect the security of medical records to ensure that confidentiality is maintained
• Identify compile and code patients using ICD10 and CPT and other standard classifications coding systems
• Enter data such as history and extent of disease diagnostic procedures and treatment into computer database
• Compile abstract and maintain patient medical records to document condition and treatment
• Review records for completeness accuracy and compliance with regulations
• Initiate processes to follow up on rejected claims
• Phone interactions with insurance agencies

PHYSICAL REQUIREMENTS

• Continuous sitting throughout the work shift
• Frequent bends kneels and crouches
• Must be able to read small print
• Stooping and bending to files supplies mobility to complete tasks
• Repetitive movements of hands fingers and arms for typing and/or writing during work shift
• Frequently lifts carries or otherwise moves and positons objects weighing 1020lbs
• Continuous use of the telephone to verbally speak to insurance companies and/or assigned by senior management
• Ability to reach with hands and arms
• Must be able to handle stress
• Will view computer screens for long periods of time.
• Must be able to work standard office equipment: computers fax machines copiers printers telephones etc.
• Work requires hand dexterity for office machine operation

Remote Work :

No

Employment Type :

Fulltime