Physician Coder I – Medicare Wellness and Transitional Care Management

Physician Coder I – Medicare Wellness and Transitional Care Management

Requirements

• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC)
• Professional Coder Apprentice (CPC-A) certification issued by the American Academy of Professional Coders (AAPC)
• Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA)
• Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA)
• Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
• Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
• Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC)
• Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist
• Knowledge of medical terminology, anatomy, physiology and ICD, CPT and HCPCS coding guidelines
• Intermediate computer skills including the use of Microsoft Office and e-mail as well as exposure or experience with electronic coding systems or applications
• Excellent oral and written communication and interpersonal skills
• Excellent organization, prioritization and reading comprehension skills
• Excellent analytical skills, with a high attention to detail
• Ability to work independently and exercise independent judgment and decision making
• Ability to meet deadlines while working in a fast-paced environment
• Ability to take initiative and work collaboratively with others

Responsibilities

• Assigns codes using International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)
• Sequences diagnoses and procedure codes as outlined in CPT, ICD and HCPC Coding Guidelines while adhering to local and national governmental payer guidelines
• Adheres to the organization and departmental guidelines, policies and protocols
• Reviews all provider documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes
• Follows up and obtains clarification of inaccurate documentation as appropriate
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and the American Academy of Professional Coders. Adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes
• Maintains the confidentiality of patient records. Reports any perceived non-compliant practices to the coding leader or compliance officer
• Meets and exceeds departmental quality and production standards
• Responsible for processing coding claim appeals and coding claim rejections, when applicable

Preferred Qualifications

No preferred qualifications provided.