ESSENTIAL FUNCTIONS
- Abstracts data in compliance with national, regional, and local policies, and interprets and reviews medical record documentation to assign accurate ICD-10 diagnosis and CPT procedure codes.
- Utilizes practice management system (PMS) to accurately account for demographics and services performed for all scheduled and unscheduled surgical cases according to standard procedures and coding guidelines.
- Utilizes individual hospital medical record systems and coordinates with physicians and staff to obtain clinical documents and demographics required for appropriate coding and billing for all hospital procedures.
- Provides education and support to clinical areas regarding appropriate documentation and coding of services to achieve accurate billing. Maintains effective communication with providers concerning coding issues.
EDUCATION
- High school diploma/GED or equivalent working knowledge preferred.
- Accredited by the American Health Information Management Association (CCS-P) or the American Academy of Professional Coders (CPC).
EXPERIENCE
- At least three years of experience in provider coding and medical terminology with extensive knowledge of ICD-10, CPT, and HCPC coding required.
- Preferred specialty experience in areas of Orthopedics, Neurology, Physical Medicine, and Rehabilitation or Pain Management.
REQUIREMENTS
- A minimum of one of the following credentials: CCS-P or CPC.
- Meets established coding and abstracting quality and productivity standards.
- Experience with various coding software. Previous experience with remote coding is preferred. Possesses PC skills, both keyboarding and applications.
- Requires a good understanding of anatomy, physiology, medical terminology, and disease processes.
- Ability to work independently.
- Excellent attention to details.
KNOWLEDGE
- Demonstrates knowledge of sequencing diagnoses and procedure codes outlined in the ICD-10-CM Official Coding Guidelines, Uniform Hospital Discharge Data Set, CMS guidelines, and other resources as applicable.
- Knowledge of government and commercial insurance plans requirements.
- Understands and applies medical terminology, anatomy, physiology, surgical technology, pharmacology, and disease processes.
SKILLS
- Skill in customer service and an understanding of The HOPCo code of conduct and culture.
- Skill in communicating effectively with physicians, clinical staff, and the public.
- Skill in establishing good working relationships with both internal and external customers.
ABILITIES
- Ability to maintain patient confidentiality.
- Ability to communicate with internal and external customers professionally.
- Ability to work independently.
ENVIRONMENTAL WORKING CONDITIONS
- Normal office environment.
PHYSICAL/MENTAL DEMANDS
- Requires sitting and standing associated with a normal office environment.
- Some bending and stretching are required.
- Manual dexterity using a calculator and computer keyboard.
ORGANIZATIONAL REQUIREMENTS
- HOPCo Mission, Vision, and Values must be read and signed.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.
