Current Openings

 

We are currently seeking Certified Medical Coders/Auditors.

 

DEPARTMENT: Coding and Auditing

STATUS: Full-time

LOCATION: Modena Office

 

The Certified Professional Coder reviews and codes outpatient medical visits for multispecialty practices, resolves complex coding scenarios, provides feedback and documentation advice to the Providers and assists with the resolution of coding related denials.

 

Responsibilities:

 

• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-9 / ICD-10 CMcoding to these services.

• Assists Denial Specialist and third party billing vendor staff to research claim denials and develop appeals by providing correct coding logic, references, as well as the assembly and review of appropriate provider documentation for accuracy and completeness.

• Reviews and codes diagnoses and other procedures in accordance with established coding and abstracting guidelines (CPT, HCPCS and ICD-9 / ICD-10 CM resources) as a part of medical records review.

• Reconciles medical record documentation, coding, claims and reimbursement data.

• Performs medical record reviews and assigns appropriate ICD-9-CM/ ICD-10 CM diagnosis codes for new and existing members based on available documentation.

• Identifies trends and ongoing problems related to medical documentation and recommends possible solutions.

• Assist in the development of provider billing manuals, specifically around the procedure and diagnosis coding of claims.

• Utilizes data and related modules to obtain, analyze and interpret coding, denial and other reimbursement data to support compliance and plan management activities.

• Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT, HCPCS, and ICD9/ICD-10 materials, Federal Register , and other pertinent guidelines.

 

Requirements:

 

• AAPC Certified Professional coder (CPC) and or AHIMA Certified coding Specialist – Physician (CCS-P) and must have a least one of the following:

• Minimum of three (3) years of experience in coding and or reimbursement activities is required in a multispecialty practice and or hospital setting. A clinical background and pervious chart abstraction experience is preferred.

• Experience with 3M encoding product or Encoder Pro preferred.

• Knowledge in medical coding and CPT, HCPCS and ICD-9 CM/ ICD-10 CM.

• Knowledge of E/M, coding and reimbursement practices/strategies.

• Knowledge of ECW billing system and/or other related billing system.

• Must have strong knowledge of physician practice coding and regulatory compliance.

• Proficient computer skills – MS Word, Excel, and Outlook.

• Detailed oriented and able to meet targeted deadlines.