Coder – Full-Time – Business Services Department

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Northern California Medical Associates is an Equal Opportunity Employer


Position title: Coder

Department: Business Services

Location: Santa Rosa, Calif.

Schedule: Full-time, 8 a.m.–4:30 p.m.

Summary

Applies the appropriate diagnoses, surgical and procedural codes to individual patient health information for data retrieval, analysis and claims processing. Works closely with departments to optimize reimbursement, ensure charge capture, reduce late charges and provide feedback to providers. Provides physicians routine feedback on documentation and compliance standards. Resolves pre-bill edits and appropriate follow-up. Exercises judgment within generally defined practices and policies in selecting methods and techniques for obtaining solutions.

Duties and responsibilities

(includes, but is not limited to the following)

  • Applies CPT-4, ICD-9, ICD-10, HCPCS and modifiers following coding guidelines.
  • Utilizes correct coding practices to file clean claims aiding in improved cash flow.
  • Provides feedback to physicians related to documentation issues and/or revenue opportunities.
  • Ensures all services are accounted for and billed.
  • Keeps abreast of coding guidelines and reimbursement reporting requirements.
  • Adheres to official coding guidelines.
  • Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
  • Code all documented professional services and submit for billing.
  • Ensure coded services, provider charges and medical record documentation meet appropriate guidelines or standards.
  • Utilize appropriate methods to ensure all documented professional services are submitted timely.
  • Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
  • Attend meetings as requested.
  • Participates in professional development activities.
  • Performs related work as required.

Supervisory

  • This position has no direct supervisory responsibilities.

Education, licensure and/or certifications

  • High school diploma or GED.
  • AHIMA or AAPC certification preferred.

Experience

  • Previous experience in medical billing preferred.

Knowledge, skills and abilities

  • Extensive knowledge of medical coding practices including CPT, ICD-9 and ICD-10, HCPCS.
  • Extensive knowledge in use and application of Correct Coding Initiative Edits and CMS National and Local Coverage Determinations.
  • Skill in using computer, adding machine, and other office equipment.
  • Ability to examine documents for accuracy and completeness.
  • Ability to read, understand, and follow verbal and written instructions.
  • Ability to establish and maintain effective working relationships with physicians and employees.
  • Ability to communicate clearly both written and verbal.
  • Skill in answering the telephone in a pleasant and helpful manner.

Physical demands

The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Requires prolonged sitting, some bending, stretching and occasional lifting of up to 25 pounds.
  • Requires use of a telephone.
  • Requires manual dexterity to operate keyboard, calculator, copy machine and other office equipment.
  • Requires eyesight correctable to 20/20 to read numbers, letters and computer monitor.
  • Requires hearing within normal range for telephone use.

Work environment

The work environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The environment is typical of a normal office environment.