Coder, Certified

Nature of Duties:

Primary responsibility is to review the medical record, obtain indications for services provided and perform accurate coding to the highest level possible. Complete superbill documentation and forward to the billing department. Educate and communicate to their providers, Office Team Leader, and/or Compliance Department when there is a lack of proper indications for services.

Qualifications:

• High school diploma
• LPN and/or CPC/CCA or Coding experience preferred
• Basic computer knowledge
• Should have Basic Life Support skills
• Good Communication Skills
  
  
  

Specific Duties:

• Review the medical record and the services provided. Assure all services were charged and priced properly. Utilize nursing knowledge and available resources to code services to the highest level by selecting the most appropriate ICD-9 code. Be alert to the following areas: dates of service, need for signatures, accurate and complete documentation, etc. to complete the coding process and superbills. Code CIS bloodwork with proper indications and ICD-9 codes.
• Assess appropriate utilization of services and communicate to the Clinic Coding Team Leader and/or physician when services lack appropriate indications. Verify proper referring physician and/or the physician supervising tests. Assist in the billing/denial process by reviewing coding practices and making necessary changes. Assist the pre-certification personnel by providing coding information.
• Answer questions regarding coding and proper indication use for nurses, technicians and/or physicians. Assist in the education of the other CIS coders (especially the non-medical coders) and answer their questions. Research computer for appropriate billing and coding information on patient accounts when needed. Communicate the need for CPT’s to the billing team leader to place into the computer.
• Forward complete superbill to the billing department for posting. Answer questions proposed by the billing department regarding superbill or coding. Prepare superbills in a timely manner especially at the “end of month” to assure timely billing of services.
• Assist the Correspondence Department as directed by Clinic Coding Team Leader. Work cooperatively with the Clinical Data/Correspondence Team Leader and/or staff of the correspondence department. Coordinate the referral tracking process and collect clinical information on patients through the review of the clinic medical record, hospital record and/or communication with the physicians, staff, patients and/or family members. Communicate relevant information and network clinical information to the physicians, staff, patient and/or family members. Report any problems identified through clinical record review to the team leader.
• Performs other related duties as assigned and serves in whatever other capacity deemed necessary for successful completion of the mission and goals of CIS and in concordance with its patient philosophy.