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Certified Professional Medical Coder

Cps

Posted on: 21 Mar 2024

Job Location: Saginaw, US

Job Description:

Position Summary

The Coding Consultant will review medical records, verify coding accuracy, and provide a summary of findings. Assist with presentation of educational information to Clients and Staff, through teamwork and communication, to ensure that education is inclusive of information needed to maintain or improve quality of coding and billing. Will work as a coding contact and resource for Billing Staff. The Coding Consultant will possess excellent communication and customer service skills while striving to maintain an efficient and productive office.

Key Objectives

Abstracts clinical information from medical records and assigns the appropriate CPT and ICD-10 codes using industry-standard coding guidelines for various specialties
Maintains up-to-date knowledge of coding and documentation requirements
Responsible for sharing and presenting CPT, ICD-10 changes that take place
Assist staff with coding questions
Some medical billing duties
Perform coding audits at client offices

Chart Audits
Billing reviews
Workflow analysis
On-Site Billing

Educates client providers and staff on documentation & coding guidelines and changes to ensure compliance with state and federal regulations
Provides measurable, actionable solutions to client providers that will result in improved accuracy for documentation and coding best practices
Responsible for lead generation for consulting services
Internal audits to present to compliance team
Ability to travel within state to client locations
Testify on any audit that go to litigation
Ensure clients are assisted in a courteous and expedient manner
Meet and exceed goals set forth through the annual performance evaluation process
Growing use and knowledge of applicable company technology, paperless systems, tools and processes

Qualifications

Associates Degree, Business Administration or equivalent; or the combination of education and work experience that enables the performance of all aspects of the position is required
AAPC Certified Professional Coder (CPC) REQUIRED
Ability to code conditions and procedures using ICD-10-CM and CPT
Knowledge of medical terminology and anatomy
Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
Use of computer systems, software, 10 key calculator
Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
Able to work in a team environment.
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
Knowledge of accounting and bookkeeping procedures.
Strong communication and presentation skills
Proven relationship building skills with clinical and non-clinical personnel

Preferred Qualifications

Certified Professional Medical Auditor (CPMA) certification
Actively pursue learning and development opportunities
Participate actively in all on-the-job and formal learning and development opportunities to understand role and responsibilities
Ability to accept and adjust to changing priorities and circumstances

Leadership

Reports to direct supervisor
Take charge and be action-oriented and persist until the task or job is completed
Learn and understand how position is critical to the success of the organization and be willing to accept responsibility and be accountable for own actions

Technology

Experience with Microsoft Office
Medical Billing workflow software
Understand and stay current on new technology

Open to 3 years plus or highly experienced

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