Under the Supervision of the Coding and Compliance Manager is responsible for accurate coding and data entry of provider office, inpatient and outpatient charges into the billing system. Maintains an extensive knowledge of CPT Procedural Coding, ICD-10 Diagnosis Coding and HCPCS Level II coding along with health information documentation standards.
DUTIES & RESPONSIBILITIES:
- Responsible for batching of charges, date receipt stamp all charges, adding ICD-10 diagnosis codes to charge documents, and verifying appropriateness of CPT procedure codes as defined by coding conventions and correct coding initiative for service(s) performed.Seque3nces charges entered by Relative Value Units (RVUs)
- Enters provider charges into the billing system with a 95% accuracy rate within 48 hours of receipt of charge(s).
- Provides education into proper documentation of services, and coding education to providers.
- Provides accurate answers to coding questions from physicians, other providers, and business office staff.
- Codes for multiple specialties, as opposed to single specialty.
- Utilizes the EMR as needed to assist with accurate coding..
- Assists with the development and recommends changes to policies and procedures to improve professional coding
- Analyzes billing reports to ensure 100% charge capture.
- Assists with monthly pre-billing audits.
- Assists with the yearly charge ticket updates
- Maintains working knowledge of CPT-4, ICD-10, HCPCS coding principles, governmental regulations, and third party requirements regarding billing and billing documentation.
- Attends all required in-service programs and employee informational meetings as designated by Supervisor.
- Practices time management, keeping authorized break periods within accepted policy. Maintains level of productivity as established for the department.
- Complies with established SDMG attendance policy.
- Provides proper notification for absences and scheduled time-off in accordance with SDMG policy.
- Complies with SDMG policies and procedures pertaining to Incident Reporting and promptly notifies Supervisor 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.
- Will attend OSHA training upon hire and annually thereafter.
- Other duties as assigned by Manager.
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
Associates degree preferred. CPC or CCS-P credential required. In-depth knowledge of CPT-4, ICD-10, HCPCS Level II coding required along with medical terminology and abbreviations. 3 years experience with broad-based knowledge of multi-specialty services, computerized billing system, and 3rd party billing regulations. Maintains working knowledge of CPT-4, ICD-10, HCPCS coding principles, governmental regulations, and third party requirements regarding billing and billing documentation. Continuing education required to maintain credentials.