Certified Coder

SB CLINICAL PRACTICE MANAGEMENT PLAN INC; Stony Brook (NY); On-site; USD 38,000 - 48,000; Full time

Job summary

SB CLINICAL PRACTICE MANAGEMENT PLAN INC; Stony Brook Orthopaedic Associates, UFPC seeks a Certified Coder in Stony Brook, NY. The role reviews and analyzes physician documentation, CPT, and ICD-10 codes to ensure compliant coding and proper reimbursement.

Qualified candidates hold CPC certification, an Associate’s degree (or 5 years of equivalent experience), and proficiency in Word/Excel. Excellent communication and strong organizational skills are essential for this on-site position.

Qualifications

• Certified CPC certification is required.
• Associate degree or 5 years of relevant experience in coding.
• Solid knowledge of medical coding requirements and guidelines.
• Strong written and verbal communication skills and organization.

Responsibilities

• Review and analyze physicians’ documentation, CPT, and ICD-10 codes.
• Ensure coding accuracy to maximize reimbursement and compliance.
• Resolve discrepancies on coding related issues and appeal rejected claims.
• Maintain IDX reports and monitor open encounters and TES TES files.
• Support CLIA renewals for all sites and other duties as assigned.

Education

Certified Professional Coder (CPC) Certification

Associate’s Degree

5 years of experience in lieu of degree

Working knowledge of coding requirements

Excellent expressive and written communication skills

Highly organized

Proficient in Microsoft Office Word and Excel

Tools

Microsoft Office Word

Microsoft Excel

Job description

Certified Coder - Stony Brook Orthopaedic Associates, UFPC

Location Stony Brook, NY

Schedule Full Time

Days/Hours Monday - Friday; 830 AM - 5 PM

Pay $27.91 - $34.87

Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Individual compensation discussions begin during the hiring process and may occur during job review and promotional opportunities. Salaries vary depending on experience, education and current market for the position. Human Resources determines the external and internal equitable salary for each employee. The above salary range (or hiring range) represents Stony Brook CPMP’s good faith and reasonable estimate of the range of possible compensation at the time of posting

SUMMARY

This incumbent is responsible for reviewing and analyzing physicians’ documentation, CPT, and ICD-10 diagnosis codes. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines.

Job Duties & Essential Functions

• Provide a variety of complex and technical assignments relating to medical coding.
• Analyze, code, and abstract information for the purpose of assigning and entering appropriate and consistent diagnoses and procedure codes for reimbursement.
• Resolve discrepancies on coding related issues.
• Review and correct rejected claims from various third party carriers.
• CPMP account notification/accounts receivable report (IDX), ICD-10 coding.
• Account maintenance - IDX pending report.
• Track all IDX record requests.
• Maintain PK files for validity, coding/billing errors.
• Monitor TES Open Encounter file.
• CLIA renewals for all sites.
• Perform all other duties as assigned by management.

Required Qualifications

• Certified Professional Coder (CPC) Certification.
• Associate’s Degree.
• In lieu of an Associate’s degree, 5 years of experience is required.
• Working knowledge of coding requirements.
• Must have excellent expressive and written communication skills.
• Must be highly organized.
• Must be proficient in Microsoft Office Word and Excel.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is largely sedentary and requires the employee to remain stationary for a majority of the day. Any additional physical demands will be outlined and provided by management.

The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of CPMP.

StaffCo is a Professional Employer Organization, commonly referred to as a PEO, duly organized and registered under the New York Professional Employer Organization law. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Clinical Practice Management Plan employees and responsible for all aspects of employment, including hirings, promotions, disciplines, terminations, the day-to-day direction and supervision of work, as well as labor relations and collective bargaining. StaffCo is fully responsible for providing all payroll and human resources services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all employee benefits. SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.

Given StaffCo’s employment responsibilities, it is deemed the “employer” for employment and labor law purposes. Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY. The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board.

CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.

CPMP expressly prohibits any form of workplace harassment based on race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected status. Improper interference with the ability of CPMP’s employees to perform their job duties may result in discipline up to and including discharge.