Certified Coder (Central Billing Office)

Certified Coder (Central Billing Office) needed for busy multi-specialty practice in Myrtle Beach.  Must have excellent computer skills. Excellent pay and benefits, including medical, dental, vision, short-term disability, life insurance, and 401k.  Hours are Monday - Thursdays 7:45am - 5:15pm and Fridays 8am-12pm.  Half days on Fridays and no weekends! Remote Work Available once trained. 

GENERAL SUMMARY OF DUTIES:  Gathers charge information, codes and/or over codes physicians coding, enters charges into AthenaNet billing system, completes billing process including entering insurance information, keying of claims, and other billing/coding duties as assigned. 

SUPERVISION RECEIVED:  Reports to Coding Supervisor

SUPERVISION EXERCISED:  None

TYPICAL WORKING CONDITIONS:  Normal office environment.

EXAMPLES OF DUTIES: (This list may not include all of the duties assigned)

1. Maintains patient checklist as assigned to account for all charges through athenaNet, missing bill slip work list.
2. Works rules as assigned and code/overcode  claims as assigned. 
3. Researches all information needed to complete billing process to include: the review of the completed medical record to determine level of service, procedures and diagnoses.
4. Reviews/interprets all completed clinical documentation to determine level of service, procedures, drugs/medicine provided and accurately assign CPT, HCPCS and ICD-10 coding and create the claim in athenaNet.
5. Communicates with physicians regarding questions pertaining to procedures and other services to ensure physician has documented all services provided during encounter.
6. Reviews all clinical documentation assigned to ensure compliance with third party and regulatory guidelines, including ‘Incident to’ when applicable.
7. Responsible for accuracy of patient demographics, insurance information, etc.   This includes the proper order of primary vs. secondary insurance and opening the benefit detail to check for PCP, HMO plans, traditional, secondary qualifier etc.
8. Participates in educational activities to include coding teleconferences and continuing education units (CEUs) to maintain certification through professional affiliations.
9. Maintains strictest confidentiality and abides by HIPAA regulations.
10. Performs related work as required/assigned.

 JOB REQUIREMENTS:

KNOWLEDGE, SKILLS AND ABILITIES:  Knowledge of billing practices and clinic policies and procedures. Knowledge of coding and clinic operating policies and procedures.   Knowledge of CPT, ICD-10 and HCPCS manuals.  Strong working knowledge of medical terminology and anatomy required.  Knowledge of insurance and third party payer requirements. Skill in using computer and calculator.  Ability to examine documents for accuracy and completeness.  Ability to work effectively with co-workers as a team member.  Ability to communicate clearly.

EDUCATION:  High school diploma or GED

EXPERIENCE:  Two or more years of coding experience in a healthcare organization. Ability to gather and interpret clinical data and communicate required clinical documentation improvement (CDI) to physicians and non-physician providers.

CERTIFICATE/LICENSE:  CPC-A or CPC through AAPC/CCA through AHIMA

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as need evolves.