Coder I - Pathology, Remote, 8:00a-4:30p

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Address:

Shift:

Job Description Summary:

Job Description:

The Coder I is responsible for abstraction and assigning valid CPT, ICD-10, HCPCs codes and modifiers to ensure appropriate reimbursement in accordance with federal state, and private health plans as well as organization and regulatory guidance. This role is typically responsible for less complex coding with oversight.

Essential Functions:

• Accurately abstracts information from the service documentation, assigns and sequences appropriate CPT, ICD-10, and HCPCs codes into the appropriate billing systems, ensuring compliance with established guidelines
• Reviews and resolves coding denials
• Completes charges sessions in the assigned work queues in a timely manner
• Completes documentation meeting the current EM Guidelines for providers
• Ensures documentation meets the Teaching Physician Rules as mandated by CMS and ULH Policies prior to release of a code for billing
• Ensures documentation for Advanced Practice Providers meets the payer-specific rules prior to release of a code for billing
• Provides comments/suggestion relative to weak areas identified in the coding reviews
• Provides trending deficiencies to Senior Manager and Compliance Educator, as appropriate

Other Functions:

• Meets or exceeds organizational coding production and quality standards
• Participates in special projects and completes other duties as assigned
• Maintains daily/weekly communication with office managers, department, and providers.
• Ability to work within a team environment and meet monthly goals
• Maintain compliance with rules and regulations regarding coding
• Responds in a timely manner to questions from manager, providers, department, and representatives
• Maintains compliance with all company policies, procedures and standards of conduct
• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
• Performs other duties as assigned

Additional Job Description:

Education:

• High school diploma or GED/equivalent (required)

Experience:

• One to four (1-4) years physician coding experience (preferred)

Certification:

• Certified Professional Coder (CPC) accredited by the American Academy of Professional Coders (AAPC) (required)

• Certified Coding Specialist (CCS), Certified Coding Specialist Physician Based (CCS-P) or Certified Coding Assistant (CCA) accredited by the American Health Information Management Association (AHIMA) (required)