Certified Medical Coder II CPC

Knowledge of medical coding rules, regulations and compliance allowing to better handle issues such as medical necessity, claims denials, bundling issues and charge capture.

Knowledge of medical terminoogy, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes and identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.

Knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes, NCCI edits and LCDs.

Performs coding and abstracting on all outpatient/inpatient procedures, evaluation and management encounter documentation and/or operative report by selecting and reporting ICD-10 diagnoses, CPT and HCPCS procedure codes and append modifiers when applicable.

Knowledge of how to integrate medical coding guidelines and payor specific coding requirements.

Reviews and verifies office superbills and appropriate progress note and/or operative note.

Reports daily down coding and up coding documentation issues by practice and by physician to department Manager. Reports any physician documentation issues to department manager.

Responsible for being up to date and maintaining currrent status of coding credentials and completes annual continued education hours.

Observes work hours and provides proper notice regarding absences and tardiness, informs supervisor about own whereabouts throughout each workday.

Performs other related department duties which may be inclusive but not listed in job description.

Maintains positive working relationship with Physician Practices and communicates with office staff as needed.

CPC or CCS-P Certification Required

High School graduate

1-2 plus years experience in Coding and Billing

Knowledge of ICD-10-CM and CPT