ASC Certified Professional Coder

POSITION: ASC Certified Professional Coder

DEPARTMENT: Billing

REPORTS TO: Revenue Cycle Manager

JOB SUMMARY: The Certified Professional Coder performs various duties to accurately interpret and bill facility charges by entering the appropriate CPT, ICD-10, and modifiers into the Billing system.

EDUCATION AND EXPERIENCE:

• High school diploma or equivalent

• Coding certification Required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure

• Ophthalmology experience preferred

• Three years minimum experience in surgery facility coding.

• Knowledge of medical and insurance terminology.

• Knowledge of and ability to apply payer specific rules regarding coding, bundling, and modifiers

• Nextech knowledge is preferred.

• Strong organizational skills and attention to detail.

• Strong analytical and critical thinking skills.

• Ability to handle large volume of surgical coding

• Ability to communicate effectively with staff

ESSENTIAL SKILLS AND ABILITIES:

• Review Operative Notes Timely

• Determine appropriate resolutions based on company guidelines and policies

• Ability to navigate EMR to locate any needed documentation

• Knowledge in Microsoft Office

RESPONSIBILITIES:

• Performs initial charge review to determine appropriate ICD 10 and CPT codes to be billed to payer

• Interprets operative notes to determine services provided and accurately assign CPT and ICD-10 coding to these services

• Enter appropriate data into Nextech billing system to complete the charge process

• Identify and report documentation deficiencies and request clarification when necessary

• Work closely with Reimbursement staff to answer all inquiries regarding coding and billing

• Apply payments for non-covered/cosmetic procedures

• Research coding questions, payer policies, and reimbursement requirements as needed

• Weekly Review of unbilled encounters

• Stay current with annual coding updates and regulatory changes

• All other duties as assigned

PHYSICAL DEMANDS:

Must be able to talk on the phone to staff, leaders, physicians, and patients.

Must be able to work in different conditions (different noise levels, lighting levels, be able to stoop, bend, reach and lift up to 25lbs).