Certified Coder - PPG Business Office

Description

JOB SUMMARY
  • Classify medical data from patient records to assign ICD-10-CM and CPT codes for primary and multi-specialty physician billing. Reviews clinical billing for coding and billing accuracy. Review claim denials for coding-related issues and assist CBO collectors with resolution. Demonstrate knowledge of reimbursement guidelines and changes in payer policy. Provide guidance to clinical staff and providers where necessary. Serves as a resource for clinics on coding issues and questions as needed. May supervise an individual billing team of non-certified billers and collectors. Performs research on coding changes and payer policies on an ongoing basis.
GENERAL REQUIREMENTS
  • Adheres to the hospital and departmental attendance and punctuality guidelines
  • Performs all job responsibilities in alignment with the core values, mission and vision of the organization
  • Performs other duties as required and completes all job functions as per departmental policies and procedures
  • Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
  • Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
WORKING CONDITIONS
  • General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
  • May be required to change from one task to another of different nature without loss of efficiency or composure.
  • Periods of high stress and fluctuating workloads may occur.
  • May be scheduled as needed including overtime
  • May require occasional travel to outside facilities for meetings or education.


Qualifications

EDUCATION REQUIREMENTS
  • High School Diploma or GED (Required)
  • Vocational / Technical Degree (Preferred)
  • 2 year / Associate Degree in Health Information Management (Preferred)
EXPERIENCE REQUIREMENTS
  • 2 - 3 years Diagnosis and CPT coding in a clinic, business, or revenue cycle environment or any combination thereof. (Required)
  • 2 - 3 years Broad knowledge of medical terminology and anatomy. (Required)
  • Prior Athena experience (Preferred)
  • Coding experience for any of the following specialities: Hospitalists, Critical Care, Neonatology, Dermatology, Plastic Surgery, Cardiology/Cardiovascular, Orthopaedics and/or Gastro (Preferred)
CERTIFICATIONS AND LICENSURES
  • Required Certifications/Licensures: Coding Certification (CPC or CCS)
  • Preferred Certifications/Licensures: CPMA
GENERAL SKILLS
  • Organizational Skills
  • Communication Skills
  • Interpersonal Skills
  • Customer Relations
  • Mathematical
  • Analytical
  • Grammar / Spelling
  • Read / Comprehend Written Instructions
  • Follow Verbal Instructions
  • Basic Computer Skills
  • Microsoft Office Suite
  • General Clerical Skills
PHYSICAL REQUIREMENTS
  • Have near normal vision: Clarity of vision (both near and far), ability to distinguish colors
  • Ability to perform repetitive tasks/motion
PHYSICAL DEMANDS
  • Standing - Occasionally within shift (1-33%)
  • Walking - Occasionally within shift (1-33%)
  • Sitting - Continuously within shift (67-100%)
  • Bending/Stooping - Occasionally within shift (1-33%)
  • Twist at waist - Occasionally within shift (1-33%)
  • Pushing/Pulling - Occasionally within shift (1-33%)
  • Lift/carry up to 20 lbs - Occasionally within shift (1-33%)
  • Reaching above shoulder - Occasionally within shift (1-33%)