Certified Professional Coder

• JOB POSITION: Certified Professional Coder
  

• LOCATION: Mount Prospect
  

• REPORTS TO: Revenue Cycle Supervisor
  

• JOB DESCRIPTION: Responsible for review clinical documentation to abstract and/or validate CPT and ICD-10 coding for Podiatry based coding experience, including evaluation & management (E/M) and surgical coding experience. The coder will ensure that medical records are coded in an accurate and timely manner as well as work closely with physicians and APPs to consistently and accurately translate clinical documentation and medical records into ICD-9 and CPT codes. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.

To be successful in this role you should ensure accuracy of all information. Will be reliable, energetic and have excellent people skills.

• RESPONSIBILITIES:

• Review clinical documentation in order to assign diagnostic and procedural codes for inpatient and outpatient medical records according to the appropriate classification system
• Ensures accurate, timely, and appropriate assignment of ICD-10, CPT/HCPCS, and modifiers for the purposes of billing, internal and external reporting, research, and compliance with regulatory and payer guidelines
• Monitors documentation turnaround time and productivity, and follows up on deferred accounts or with physicians and other clinical staff as needed
• May be tasked with generating reports and/or analyzing data related to evaluation and management code utilization, CPT code application, denials, reimbursement per contracted terms, etc.
• Provides coding feedback to providers, clinical department leadership, and revenue cycle team
• Escalate coding and documentation issues to revenue cycle leadership, and assist facilitating corrective action plans
• Assists with design and implementation of workflow updates and coding tools
• Support denial team on coding related denials
• Any other duties as assigned

• QUALICATIONS:

• Certified Professional Coder (CPC) or Certified Coding Specialist- Physician Based (CCS-P) required
• Certification in conjunction with physician based coding experience, including evaluation & management (E/M) and surgical coding experience
• A minimum of three (3) years of coding experience, Podiatry coding experience preferred
• Knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing, with demonstrated ability to interpret such guidelines
• Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in CPT, ICD-10-CM and HCPCS code assignment
• Demonstrates commitment to continuous learning
• Proficient in Excel, Word, Data Entry, computerized health care billing software knowledge, experience in
• EClinical Works a plus
• Excellent verbal and written communication skills.
• Proficient touch-typing skills.
• Ability to focus for extended periods.
• Ability to manage multiple priorities and projects
• Excellent time management skills
• Ability to lead by example
  

• OTHER QUALIFICATIONS:

• Self directed and willing to take initiative
• Open minded to change
• Decisive, not afraid to make a decision
• Willing to roll up sleeves and pitch in with staff and doctors to solve problems
• Team oriented with a collaborative approach to problem solving
• Quantitative focus, creates a fact based, “no blame” culture
• Patient focused
• Proven ability to prioritize and organize
• Committed to continuous performance improvement
• Function effectively in a fast-paced work environment

• COMPENSATION:

• Competitive compensation
  

• EDUCATION:

• High School Diploma/GED required. Bachelor’s Degree preferred

• TRAVEL:

• Minimal Travel between multiple clinic locations and Mount Prospect location as needed - valid driver’s license required

• BENEFITS:

• Standard

• PHYSICAL DEMANDS:
  • Physical demands to successfully perform the essential functions of this job including but are not limited to walking, sitting, stooping, kneeling, standing, and crouching

• The employee must be able to regularly lift up to 10 pounds
• No specific vision requirements
• No specific noise requirements

AMERICAN WITH DISABILITIES ACT (ADA) SPECIFICATIONS

Qualified individuals with disabilities may make a request for reasonable accommodation to the Director of Human Resources. Upon receipt of an accommodation request, the Director of Human Resources will meet with the requesting individual to discuss and identify the precise limitations resulting from the disability and the potential accommodation that might help overcome those limitations. The Director of Human Resources in conjunction with a medical review (and, if necessary, other appropriate management representatives) will determine the feasibility of the requested accommodation and the impact on the business operation. The Director of Human Resources will inform the qualified individual of the decision of the accommodation request or how to make the accommodation.

Employee Printed Name

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Employee Signature Date

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Supervisor Signature Date

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Human Resources Signature Date