Certified Coder
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Job Description
Certified Coder at Ohio State University Physicians responsible for billing services and compliance. Analyzing medical coding and providing training to healthcare providers and staff.
Responsibilities:
- Determines accurate CPT, HCPCS procedure and professional supply codes and ICD-10-CM diagnosis codes used for billing services provided by physicians and licensed non-physician providers
- Performs activities related to physician practice management and coding to maintain compliance with payer reimbursement policies and Federal health care program requirements
- Provides training and education on coding and compliance issues to physicians, non-physician providers and staff on an ongoing basis
- Interacts with patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation as well as communication on coding and compliance issues
- Performs audits and analyses of payer denials; provides information on compliance issues arising from audits and formulates recommendations to providers regarding improved documentation practices to avoid future claims denials
- Researches inquiries from providers and patients about fees, reimbursements, and denials
- Monitors data sources to ensure receipt and analysis of all charges
- Updates encounter forms/super bills on an annual basis with respect to diagnostic, procedural and supply code changes
- Attendance, promptness, professionalism, the ability to pay attention to detail, cooperativeness with co-workers and supervisors, and politeness to customers, vendors, and patients
- Other duties or special projects as assigned.
Requirements:
- High School diploma or GED
- Certification in CPC, CCS, CCS-P, RHIT; or specialty coding with one to three years’ experience directly related to coding and reimbursement for physician services; or equivalent combination of education and experience
- Knowledge of CPT, HCPCS procedure and professional supply codes and ICD-10-CM (or current version) diagnosis codes used for billing services provided by physicians and licensed non-physician providers
- Knowledge of third party fee profiles and reimbursement requirements
- Knowledge of current and developing issues and trends in medical coding procedures and requirements
- Analytical ability to gather and interpret data and develop, recommends, and implement solutions
- Ability to interact and communicate with individuals at all levels of the organization
Benefits:
- medical, dental, vision
- health reimbursement accounts
- flexible spending accounts
- retirement
- employee assistance program
- paid time off
- holidays
- wellness program
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