Certified Coder PPG CBO

Qualifications

• High School Diploma or GED (Required)
• Vocational / Technical Degree (Preferred)
• 2 year / Associate Degree in Health Information Management (Preferred)

Work Experience

• 2 - 3 years Diagnosis and CPT coding in a clinic, business, or revenue cycle environment or any combination thereof. (Preferred)
• 2 - 3 years Broad knowledge of medical terminology and anatomy. (Preferred)

Licenses and Certifications

Required Certifications/Licensures: Coding Certification (CPC or CCS)

Preferred Certifications/Licensures: CPMA

Essential Functions

CODING SKILLS

• Review medical records to assign ICD-10-CM, CPT, and HCPCS Level II codes and modifiers for accurate primary and multi-specialty billing.
• Provides analysis and education on coding trends and changes in payer policies to providers and staff.

CODING REVENUE CYCLE SKILLS

• Review claim denials for coding issues, interpret payer guidelines, and assist insurance collectors with resolution for proper reimbursement.
• Prepare or assist with appeals process as necessary.

CODING PRODUCTIVITY

• Performs coding duties accurately and timely to ensure appropriate reimbursement and maintain revenue flow continuity.

Additional Duties

• 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.
• Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs.
• For non-clinical areas, has attended training and demonstrates usage of age-specific customer service skills.
• Wears protective clothing and equipment as appropriate.