Certified Medical Coder

Job Description:

Description

* Responsible for extrapolating information from claims and medical records to verifying is billing accurate and follows standard practice guidelines
* Responsible for research of all relevant standards and regulations
* Acts as resource to providers and staff to assist them in meeting compliance as well as billing regulations
* Participate in audits as directed Monitor and maintain systems for tracking of provider and company issue in relation to billing practice
* Validates the accuracy and sequencing of assigned ICD-9-CM codes to assure the correct DRG was assigned to each case
* Ensures that all data abstracted is consistent with guidelines outlined by JCAHO, OSHPD and CMS, regional and local policy.
* Work closely with providers to resolve billing issues
* Respond professionally to all client and provider inquiries

Job Requirements

* Minimum 2 years prior experience as a Medical Coder or Certified Coder, preferably in an insurance setting. High school degree or higher.
* Must is required to maintain a license as a Certified Procedural Coder (CPC or CCS-P credential of at least 1 year by AHIMA or AAPC).
* Must have working knowledge of medical terminology, anatomy and physiology, and ICD-9-CM/CPT coding.
* Can follow accepted coding principles to assign all diagnoses and procedure codes for inpatient or outpatient records utilizing ICD-9-CM and CPT.
* Requires excellent communication, customer service and organizational skills.
* Ability to work independently while following company guidelines and procedures
* Must be able to operate a computer in a MS Office Profession version- Excel, Word, Access, Outlook
* Knowledge of coding principles, State and Federal laws, and regulatory bodies as it pertains not only to coding, but to Medical Record processes is necessary.
* Working knowledge of JCAHO standards preferred