Certified Professional Coder

Job Title: Certified Professional Coder Department: Clinic Job Function: Responsible for managing, directing and supervising, reimbursement/coding activities on all services including, securing, maintaining and distributing the most current coding information and implementing changes. Job Qualifications: Education: High school diploma Minimum of one-year experience in a clinic setting Up to date Professional Coding Certificate Job Duties and Responsibilities: Maintain acceptable CPT and ICD-10 coding standards.

Maintains procedure code master file. Evaluates and develops new entries Reviews reimbursement from third party payers to ensure payment through proper use of codes. Maintains diagnosis code master files which includes identifying inappropriate codes and informing appropriate medical staff. Maintains fee ticket system including creating, updating and printing tickets as necessary.

Gathers, audits, corrects clinic fee tickets including checking for accurate patient demographic information and total charges by monitoring patients’ chart to verify ticket information. Maintains fee schedules for Medicare, fee for service, health maintenance organizations. Works with medical staff to resolve coding issues and associated problems.

Monitors Medicare reimbursements and maintains files. Assures information is available for peer and Medicare review. Participates in educational activities and seminars Performs billing audits to determine documentation and level of service Knowledge of: Coding policies and procedures, reimbursement practices, record physiologic and growth indices.

Health insurance processing and clinic operating policies Third-party fee profiles and reimbursement requirements Skilled in: Advanced computer coding applications Identifying and resolving complex coding problems Exercising initiative, judgment, discretion and decision-making to achieve organizational objectives. Establishing and maintaining effective working relationships with patient's medical staff and the public.

Ability to: Communicate information effectively with patients, medical staff and others. Examine insurance documents for accuracy and completeness. Prepare insurance records in accordance with detailed instructions. Work effectively with patients and co-workers. Communicate effectively and clearly. Other duties as assigned.