Certified Medical Coder

Title:                           Certified Medical Coder

Position Summary:   Performs all coding for Omni Family Health practices to ensure consistency and meet compliance guidelines needed to ensure appropriate and effective reimbursement. Supports Omni Family Health Physicians and hospital-based providers with monthly physician reimbursement and act as a back up to the department supervisor. Develops policies and procedures to support coding guidelines.

Job Duties:

The following are essential job accountabilities:

  1. Ensures completion of documentation and coding on billing slip and HER when needed for correct and complete claim. 
  1. Read and interpret patient medical information and apply correct ICD-10, CPT and HCPCS codes as needed for optimal reimbursement.
  2. Research documentation with physician and/or Non Physician Provider (NPP).
  3. Post charges for both out-patient and in-patient facilities for multiple providers to ensure accuracy of coding and patient accounts including following up with providers and putting together a complete file for accurate posting of charges
  1. Schedules and coordinates monthly and quarterly coder educational seminars. Provides documentation and feedback to Supervisor, Coding & Compliance as needed to support certified coders on-going education.
  2. Supports the incoming charges processed through NextGen EHR including monthly reconciliation and finalizing.
  3. Acts as a coding resource for Omni Family Health physicians and clinic staff.
  4. Various other work-related duties as assigned by supervisor. These duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.

Additional Duties

  1. HIPAA compliance – Responsible for enforcing compliance with all HIPAA regulations and requirements. Treats all member information confidential.
  2. Compliance – Ensure compliance with all local, state, and federal regulations.
  3. QA/QI – Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
  4. IT – Required to learn and use the Electronic Health Record and Practice Electronic System and its components as required by the job functions and highlighted in the Policies and Procedures.
  5. All employees will participate in Patient Centered Home Health Model at Omni Family Health.

 

Qualifications, Education, and Experience

Education:

  1. High school graduate

Experience:

  1. Possess three years of medical billing and accounts receivable experience.

Certification:

  1. CPC, CPCH, and /or CCS-P certification required

Skills:

  1. Basic knowledge of CPT and ICD10 codes.
  2. Minimum of 5 years multi-specialty physician billing and leadership experience.
  3. Ability to operate computers, Microsoft operating system and provide direction to staff as needed.
  4. Must be able to take responsibility and work under pressure.
  5. Ability to work under pressure.
  6. Ability to handle multiple functions.
  7. Demonstrate effective communication skills with medical/dental providers and staff.