Coder I

Demonstrates compliance with Code of Conduct and compliance policies and takes action to resolve compliance questions or concerns and report suspected violations.
2. Maintains quality of work based on current published standards.
3. Reviews documentation and sequences diagnoses and procedures using current coding guidelines for E&M and simple visit encounters.
4. Completes claim information and validates for split or nonsplit payers.
5. Communicates with Coder IIs department management and clinic staff to obtain needed documentation to ensure correct billing.
6. Completes assigned work queue assignment within departmental productivity standards.
7. Obtains and maintains a 95% accuracy rate.
8. Maintains a thorough understanding of anatomy and physiology medical terminology disease processes through participation in continuing education programs to effectively apply ICD10CM and CPT4 coding guidelines to inpatient and outpatient simple visit encounters.
9. Performs other duties as assigned.

Licensure/Certification
Required: coding certification program: CPCA CPC CSC or RHIT
Experience
Required: One (1) year of experience in billing/charge capture coding or related services
Specific Skills Knowledge Abilities Required
ICD10CM & CPT/HCPCS coding conventions
Knowledge of anatomy and physiology
Knowledge of medical terminology
Coding software familiarity
Effective written and verbal communication skills
General computer skills to include Excel Word and Power point
Knowledge of Denial and appeals process
Knowledge of general CMS guidelines and general billing guidelines

Required: High School Diploma GED or higher level degree