Coder IP/OP - FT

The IP/OP Coder converts diagnoses, procedures and E/M services into codes based on CPT and ICD-10 guidelines, by reviewing physician/provider documentation and accurately applying the correct coding. The Coder is responsible for professional communication with the physician/provider(s) he/she codes for, as needed, for clarification of documentation and to ensure all coding is captured. The Coder is responsible to keep current knowledge with all payer guidelines, and to apply those payer guidelines as appropriate when coding.

The IP/OP Coder converts diagnoses, procedures and E/M services into codes based on CPT and ICD-10 guidelines, by reviewing physician/provider documentation and accurately applying the correct coding. The Coder is responsible for professional communication with the physician/provider(s) he/she codes for, as needed, for clarification of documentation and to ensure all coding is captured. The Coder is responsible to keep current knowledge with all payer guidelines, and to apply those payer guidelines as appropriate when coding.

Scope:

The IP/OP Coder must maintain ethics at all times. The IP/OP Coder can only code what is clearly documented by the physician/provider.

Essential Duties and Responsibilities:

• Reviews clinic notes, H&P, Consult, procedures and surgeries to apply accurate CPT coding and ICD-10 coding to the highest specificity.
• Monitor and make necessary changes to any charge under review using medical records and physician documentation. Communicates with physician/provider when clarification is needed regarding documentation that affects outcome of coding.
• Documents clearly any coding steps take on account for clear history of actions.
• Maintains productivity standards on a regular basis as evidenced by ability to complete tasks and remain current within scheduled hours per week.
• Research and maintain current payer specific coding guidelines, and apply those as appropriate when coding.
• Work denials and write appeals, as necessary, to payers in order to obtain reimbursement.
• Apply correct coding hierarchy to CPT and ICD-10 codes.
• Work coding and diagnosis holds.
• Communicate documentation education to physician/provider, as needed, when lack of detail in documentation could lead to more specific or add-on coding. Provides education to physician as needed.
• Provides coding education and materials to all employed physicians within the first 30 days of employment.
• Provides data for administration review and/or audits.
• Assists management with special projects.
• Maintain CHS assigned coding modules.
• Work closely with other coders and provide backup as needed to cover vacations or high volume periods.
• Ability to work with deadlines, e.g, month end, with the knowledge that coding is expected to be completed timely.
• Code and enter charges within 48 hours of receipt.
• Communicate with Management when the physician/provider is behind on submitting charges for coding.
• Communicate with Management when the physician/provider is behind on submitting charges for coding.
• Maintains current knowledge on all CPT and ICD-10 changes per payer guidelines.
• Maintains personal coding license and stays current with required CEU credits.
• Maintain quality standards of 95% accuracy.
• Responsible for all other duties as assigned by leadership.
• Communicate with coders, billers and managers in a respectful and professional manner.

(CRC)- Certified Risk Adjustment coder preferred