General Position Summary:
Certified Professional Coder (CPC) to provide quality review and analysis of a wide range of patient medical records and ensure accuracy of coding and maintain records in accordance with accepted medical and legal standards. Responsible for reviewing medical records to assure proper billing of the medical record, comparison of physician chosen CPT and ICD-10 codes to the physicians' documentation to substantiate the level of coding, physician services to include identification of professional services in and complete review of medical records to accurately optimize all professional services documented for billing.
Duties and Responsibilities:
- Review of electronic medical records initiated by a health care provider.
- Verifying and coding of the diagnosis, evaluation and management, procedures or other codes required for the completeness and accuracy of the record
- Review and verify component parts of medical records to ensure completeness and accuracy of diagnosis, operations, and special therapeutic
- Codes and/or reviews principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs with International Classification of Diseases (ICD10), Current Procedural Terminology (CPT), Heath Care Financing Administration Common Procedure Coding Systems (HCPCS – all levels, and any other coding classification systems that may be required).
- Perform edit checks on data entered prior to transmittal and corrects errors as indicated.
- Analyze medical record documentation for consistency and completeness for coding purposes using established criteria and regulations
- Examine all documents in the record for authorized signature and patient identification to ensure all documents contain sufficient documentation to support the diagnosis and treatment administered, and the results obtained are adequately described.
Knowledge, Skills, and Abilities:
- A knowledge of medical terminology.
- Good verbal and written communication skills.
- Proper use of ICD-10, CPT, Revenue Codes, and HCPCS codes.
- Knowledge of all confidentiality requirements regarding patient information and strict maintenance of proper confidentiality on all such information.
- Good time management and organizational skills.
Work Experience, Education, and Certifications:
- High school graduate or equivalent.
- CPC or COC, CPC is preferred.
- CPB certification a plus, but not required
Physical Requirements / Demands:
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift to 15 pounds at times.
Essential or Non-Essential Classification:
- This position is designated as a non-essential position and therefore the employee’s presence at work during an emergency or bad weather conditions is not required to meet operational needs.
Statement of Non-Inclusivity:
This job description has been designed to describe the general nature and level of work being performed by the employee within this classification. It is not designed to contain or be interpreted as a comprehensive list of all duties, skills, responsibilities, and qualifications which may be required of or given to any employee assigned to the position. The skills, duties, requirements, and responsibilities outlined in this job description may be changed or added to when deemed appropriate and necessary by the company or the person who is designated to be managerially responsible for this position. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind. Employment with the company is an at-will relationship.