Certified Coder

This is a fully remote position, open to applicants in United States.

📋 Description

• Accountable for entering, auditing, and coding patient services to guarantee that encounters are accurately submitted to insurance payers.

• Evaluate coding-related claim issues, process gaps, and denials to provide trending feedback for providers based on location and/or specialty.

• Examine provider documentation (including hospital procedures) and convert services into appropriate codes.

• Append payer-specific modifiers and claim criteria as required.

• Review incomplete encounters and code based on available documentation in EHR systems.

• Possess a comprehensive understanding of various coding systems, including ICD-10-CM, ICD-10-PCS, CPT, Level 1 HCPCS, and Level 2 HCPCS.

• Utilize computers and billing software to create and bill encounters that result in clean claims.

• Participate in internal meetings related to EHR workflows and share optimal coding practices.

• Support Operations when coding guidance is requested for current or new services.

• Comprehend payer reimbursement and PPS visit qualification for Medicare and Medicaid.

• Identify areas where provider training or re-training is necessary.

• Monitor, analyze, and resolve tasks associated with coding edits, rejections, and denials.

• Communicate effectively with providers, patients, and insurance payers.

• Review patient accounts and rectify any missing or incorrect information.

• Investigate and appeal claims that were incorrectly denied.

• Complete coding assignments such as quarterly or ad hoc provider chart audits.

• Adjust to updates and changes in billing software.

• Carry out all other duties and tasks as assigned.

⛳️ Requirements

• In-depth knowledge and experience with Medical Terminology.

• Strong multitasking abilities, organizational skills, and teamwork capabilities.

• Proficient in using computers, Microsoft Office 360 (Outlook, Word & Excel), Adobe, and medical billing software.

• Familiarity with unfair debt collection practices and insurance regulations.

• Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS.

• Excellent communication skills with patients and healthcare companies.

• Basic knowledge of accounting and bookkeeping practices.

• Certified Professional Coder (CPC) certification along with some medical billing experience.

• Ability to communicate in Spanish is a plus.

🏝️ Benefits

• Enhanced patient confidentiality and information security.

• Opportunities for training office staff on billing and coding updates.