Medical Coder

This position is responsible for abstracting provider services accurately into billable codes from the medical documentation in accordance to the coding ethics of American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA) and/or National Alliance of Medical Auditing Specialists (NAMAS) and payer coverage guidelines. Furthermore, responsible for posting and reconciling charges and communicating with provider/staff of medical necessity of services, unspecified, truncated, and lack of supporting diagnoses along with incomplete or missing documentation. 

KEY RESPONSIBILITIES & DUTIES:

• Responsible for abstracting provider services into billable codes (CPT, HCPCS, & ICD-10) from the medical documentation in accordance with the coding ethics of AAPC, AHIMA, and NAMAS and payer coverage guidelines in an accurate and timely manner. 
• Post and reconcile hospital setting (IP/OP/OBS) charges daily.
• Communicate inefficiencies to the coding supervisor such as the medical necessity of services; unspecified truncated and lack of supporting diagnoses; incomplete or missing documentation along with any inappropriate coding and documentation trends. 
• Reference coding and payer resources to accurately code and bill the provider documented services.
• When needed, assist the AR Specialist with a complicated coding denial. Furthermore, the coder assists with creating an appeal letter regarding the coding denial along with any supporting documentation. Coder will forward the appeal documentation(s) to the AR Specialist to handle.
• Continue education with coding and billing via Encoder Pro, coding subscriptions and resources provided by CHP.
• Other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES  

• Have experience properly coding (CPT, HCPCS, & ICD-10) services from the medical documentation in accordance with the coding ethics of AAPC, AHIMA, and NAMAS.
• Must be able to communicate effectively in English, verbally, and written. Additional languages are desirable.
• Excellent customer service and phone etiquette skills.
• Must be able to maintain a high degree of confidentiality and work well under productivity standards.
• Able to prioritize and balance the workload on short and long-term company needs.
• Must be able to work independently and be able to solve problems efficiently and accurately.  
• Able to create channels of communication to obtain information necessary to perform job tasks.
• Strong organizational skills with the ability to prioritize a high-volume workload.
• Helpful attitude, positive teamwork spirit with a willingness to help.

CREDENTIALS/EDUCATION/EXPERIENCE  

• High School Diploma or Equivalent required.
• Minimum of 2 years of experience in medical billing and/or coding.
• Certifications in Medical Billing and Coding highly desirable