MED REC CODING ANALY

Job Details

Req Id 54601
Department CODING
Shift Days
Shift Hours Worked 12.00
FTE 1.0
Work Schedule SEMC NU 12 HR
Employee Status A1 - Full-Time
Union Non-Union

Job Summary

Under the general supervision of the Business Operations Manager, reviews Medical Record documentation to select and code applicable diagnoses and the following services for Medical Group providers according to ICD-9-CM and HCPCS or CPT-4 classification: Office Services – Family Practice, Internal Medicine, Pediatrics, Pediatric Pulmonology, OB/GYN Services – in patient and out patient.

Core Job Responsibilities

• Per review of Medical Record documentation, performs charge coding and diagnosis selection of out patient Family Practice and Internal Medicine billing services to include office services, point of care testing and procedures.
• Per review of Medical Record documentation, performs charge coding and diagnosis selection of out patient billing services for Pediatric and Pediatric Pulmonology services.
• Per review of Medical Record documentation, performs charge coding and diagnosis selection of out patient billing services for OB/GYN services.
• Per review of Medical Record documentation, performs charge coding and diagnosis selection of in patient or out patient OB/GYN services performed at St. Elizabeth Medical Center, St. Luke’s Hospital or Little Falls Hospital.
• Reviews progress notes for applicable diagnoses if none are indicated on the super bills.
• Applies modifiers and occurrence codes to reflect ABN and medical necessity coverage status.
• Maintains proficiency with the applicable Evaluation & Management guidelines.
• Maintains proficiency with guidelines and application of HCPCS, CPT-4 and ICD-9-CM.
• Maintains proficiency with Medicare and PCAP billing guidelines.
• Maintains proficiency with Medicaid Managed Care guidelines, i.e., Fidelis, United Healthcare, Excellus.
• Assists Site Managers or designee with review of the weekly Accounts Not Selected for Billing Report.
• Assists Site Managers or designee with correcting and making comments on charge and diagnosis related issues through the CFUM function.
• Provides ongoing educational feedback to Site Managers and Providers regarding the quality of information, i.e., registration, legibility, etc.
• Performs other related duties as requested by the Business Operations Manager.

Education/Experience Requirements

Required: CCS-P or CPC; 3-12 months experience as a Professional Coder, or 2-3 years medical office or medical out patient related experience

Licensure/Certification Requirements

Required: Certified Coding Specialist – Professional (CCS-P) or Certified Professional Coder (CPC)

EOE AA M/F/Vet/Disability

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.

Successful candidates might be required to undergo a background verification with an external vendor.