Certified Professional Coder
Job Posting for Certified Professional Coder at SSKS & Associates Management Company, Inc
General Summary of Duties: The primary duties of the CPC is to review the health record and assign CPT, and/or HCPCS, and diagnosis codes based on medical documentation. Query the physician for unclear documentation. Resolve all claim edits and rejections related to coding.
Essential Functions:
- Provide second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices
- Audit medical record documentation to identify under-coded and up-coded services; prepare reports of findings and meet with providers and provide education and training on accurate coding practices and compliance issues
- Interact with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specified documentation
- Submit any issues or trends found within documentation by a physician and/or physician extender to management
- Research, analyze, and respond to inquiries regarding compliance, inappropriate coding, denials, and billable services
- Interact with providers and management to review and/or implement codes and to update charge documents
- Other duties as assigned
Knowledge, Skills, and Abilities:
- Strong knowledge of anatomy, physiology and medical terminology
- Excellent typing and 10-key speed and accuracy
- Commitment to a high level of customer service
- Strong oral and written communication skills
- Working knowledge of medical jargon and anatomy preferred
- Able to work independently and in a group setting
- Working knowledge of Next Gen billing, Genius Doc, and I Know Med (preferred)
Qualifications:
- High School Diploma or GED
- Minimum of two years’ experience in coding and auditing. Preferably in radiation oncology, rheumatology, labs, hematology and/or oncology
- Proficient computer skills
- Certified coding certificate from an accredited organization, such as AHIMA, or AAPC
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