Certified Coder

Overview

The Certified Professional Coder will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. The Certified Professional Coder will be responsible for reviewing physician/non-physician documentation, accurately assigning CPT, ICD-10-CM and HCPCS Level II codes, and ensuring compliance with coding guidelines and regulations. Attention to detail, time management, and a high-level of customer service skills are required. We are looking for a positive team player with a strong work ethic and good attendance history. This full-time position reports to the Sr Coding Manager.

Responsibilities

• Review and analyze medical records to identify and extract relevant diagnoses, procedures, and services for accurate coding.

• Assign appropriate diagnosis codes (ICD-10-CM) and procedure codes (CPT/HCPCS) based upon medical documentation.

• Verify and ensure that all codes are accurately applied and comply with coding guidelines and regulations.

• Review and resolve coding-related denials, discrepancies, and inquiries.

• Assist physician/providers with questions regarding coding and documentation guidelines.

• Provides ongoing feedback based on observations from coding physician/provider documentation.

• Identifies opportunities for education and communicates trends to Manager.

• Review and resolve charge sessions that fail charge review edits, claim edits, and follow-up denials.

• Manage assigned charge reviews, claim edits, and coding follow-up work queues.

• Monitors charges and codes for appropriateness of modifiers in relation to NCCI/CCI edits and payer specific requirements.

• Stay updated with the latest coding guidelines, regulations, and industry changes.

• Maintain confidentiality and always adhere to HIPPA regulations.

• Perform other duties and projects as assigned.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

• Current Certification as a Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist - Physician (CCS-P) from AHIMA.

• A minimum of three years' experience in the outpatient setting (physician's office or ambulatory surgery centers) including assignment of E&M, CPT, and HCPCS codes.

• Strong understanding of anatomy, physiology, and medical terminology required.

• Ability to work independently and in a team environment.

• Effective communication skills: both written and verbal.

• Detail-oriented with high accuracy in coding and data entry.

• Ability to maintain benchmarks such as production and low error rate.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.