Family Physicians Group
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at Family Physicians Group
The Coding Specialist has specific expertise in ICD-10CM, CPT, and HCPS coding in a professional coding environment. Coder needs to have E&M coding knowledge and can conduct chart-review using E&M guidelines. Coding Specialist has knowledge of third party billing procedures across a variety of pay or systems. Additional responsibilities include helping billing staff establish the medical necessity or charges; provide feedback to the clinical staff on coding issues and reviewing denials.
Essential Functions and Duties
- Assign appropriate diagnosis codes using ICD-10-CM.
- Assigns appropriate procedure codes using CPT and HCPCS.
- Links proper diagnosis code with appropriate CPT code for billing purposes.
- Verifies the place of service.
- Query physician for when additional information is needed to complete accurate coding tasks.
- Submit statistical data with regards to weekly production.
- Attends various meetings and professional development programs.
- Abstracts select data elements in accordance with established policies to create a complete and comprehensive database.
- Must be proficient with Medicare guidelines, self-motivated and detail-oriented.
- Understanding of federal and state laws and regulations in medical reimbursement preferred.
- Understanding of anatomy and physiology, disease process, medical terminology and pharmacology.
- Processing of clinical professional charges in a timely and accurate manner, reviewing and processing claims edits for accuracy as well as insurance and coding compliance.
- Maintains and demonstrates in their daily interaction with others a positive working relationship with the various levels of staff.
- Works independently following established policies, procedures, and practices.
Education and Experience
- High School Diploma or GED required
- Certification as a Registered Health Information Technician (RHIT), or a Certified Coding Specialist Physician base (CCS-P), or Certified Professional Coder (CPC), or Certified Evaluation and Management Coder (CEMC) or Certified Family Practice Coder (CFPC)
- 2-5 years of multiple specialties, surgical and E&M coding experience.
- Participates in continuing education to maintain current standards of patient care and education relevant to position.
- Seeks out work related learning opportunities and shares work related knowledge with peers.
- Identifies strengths and weaknesses in own work to improve work performance.
- Remains aware or goals set annually and works toward accomplishing these goals.
- When applicable, maintains current national medical assistant certification on file.
- Completes or keeps existing training certification
- Accepts responsibility for attending OSHA, Compliance, and HIPPA training.
- Demonstrates awareness of OSHA regulations regarding personal protection and patient safety by following universal precautions.
- Attends and participates in department, nursing, and employee meetings.
- Actively participates in identifying and offering solutions to problems for the improvement of the position, department, or BMC.
- Participates in developing or revising departmental operating procedures.
Knowledge, Skills, and Abilities
- Knowledge of medical terminology
- Knowledge of ICD-10-CM and CPT coding systems
- Knowledge of coding and clinic operating policies
- Skill in establishing and maintaining effective working relationships with staff
- Ability to maintain confidentiality
- Ability to work well under pressure
- High degree of accuracy and attention to detail
- Good organizational and mathematical skills are necessary
- Computer knowledge and ability to learn and use a computer based patient appointments, scheduling, registration, and electronic patient record system.
- Working knowledge of Microsoft Office software, including Microsoft Excel and Word.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand and/or sit for extended period of time. The employee is occasionally required to sit. The employee must occasionally lift, push, pull and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.