Certified Medical Coder

Revenue Cycle Management
Massachusetts, Wilbraham
Posted 3 months ago

POSITION SUMMARY

Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Accurately codes office and hospital procedures for providers to ensure proper reimbursement. Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD-10-CDM, HCPCS and CPT codes.
ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Audit records to ensure proper submission of services prior to billing on pre-determined selected charges
  • Receive hospital information to properly bill provider services for hospital patients
  • Supply correct ICD-10-CM diagnosis codes on all diagnoses provided
  • Supply correct HCPCS code on all procedures and services performed
  • Supply correct CPT code on all procedures and services performed
  • Contact providers to train and update them with correct coding information
  • Attend seminars and in-services as required to remain current on coding issues; maintain all mandatory CEUs
  • Audit medical records to ensure proper coding complete and to ensure compliance with federal and state regulatory bodies; accurately follow coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
  • Maintain compliance standards in accordance with the Compliance policies and the Code of Conduct; report compliance problems appropriately
  • Determine the final diagnoses and procedures stated by the physician or other health care providers are valid and complete
  • Perform a comprehensive review of records to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports which appear to be indicated by the diagnosis accurately and by the nature of the treatment rendered
  • Review the records for compliance with established reimbursement and special screening criteria
  • Analyze provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code
  • Perform other related duties, which may be inclusive, but not listed in the job description

QUALIFICATIONS (Knowledge, Skills, and Ability Requirements)

  • CPC certification is required
  • Min. of two years certified coding experience required
  • Knowledge of medical terminology
  • Excellent computer literacy skills
  • Ability to work well with physicians, patients, co-workers, vendors and must be able to clearly communicate with them all

PHYSICAL REQUIREMENTS:

Requires sitting and standing associated with a normal office environment. Manual dexterity for using a calculator and to operate a computer and use a computer keyboard.  Bending, stooping, walking required.

SUPERVISORY RESPONSIBILITIES

Does this job have supervisory responsibilities? No
Are there subordinate supervisors reporting to this job? No
Are there other non-supervisory employees who report directly to this job? No

CERTIFICATES, LICENSES, REGISTRATIONS

CPC Certification

 

GBS Corp. is an equal opportunity and affirmative action employer. We consider all qualified applicants for employment without regard to race, color, religion, creed, national origin, sex, pregnancy, age, sexual orientation, transgender status, gender identity, disability, alienage or citizenship status, marital status or partnership status, genetic information, veteran status or any other characteristic protected under applicable law.

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