Certified Professional Coder

tryonmedicalpartners; United States; Hybrid; USD 60,000 - 75,000; Full time

Job summary

Tryon Medical Partners is seeking a Certified Professional Coder for a full-time hybrid or remote role supporting the RCM team. The position requires a CPC or equivalent certification and a minimum of three years experience in CPT and ICD-10 coding of physician services.

Responsibilities include reviewing records to assign CPT/ICD-10 codes, entering data into the billing system, and ensuring compliance with payer and regulatory guidelines.

Qualifications

• Three years’ experience with CPT and ICD-10 coding of physician services.
• CPC Certification preferred; must maintain active certification and required CEUs during employment tenure.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Knowledge of payer-specific rules regarding coding, bundling, and adding appropriate modifiers.
• Understanding of regulatory guidelines including NCDs and LCDs.
• Advanced knowledge of ICD-10 CM/PCS and CPT/HCPCS coding systems.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and ability to work in a team.

Responsibilities

• Performs initial charge review to determine correct ICD-10 and CPT codes.
• Interprets medical records to assign CPT and ICD-10 coding.
• Enter codes, diagnoses, and modifiers into the billing system.
• Maintain timeliness of charge processing and communicate with teammates.
• Query physicians regarding procedures billed for proper coding.
• Review patient logs to ensure billing is captured.
• Ensure compliance with third-party guidelines.

Skills

ICD-10 coding

CPT coding

Medical terminology

Regulatory knowledge

Analytical skills

Education

High school diploma or GED

CPC Certification

Job description

Certified Professional Coder

Job Summary:

(This is a full-time hybrid or remote position that will support the RCM team, Monday to Friday 8 am to 5 pm- Coding certification required)

Primary Job Responsibilities/Tasks may include, but not limited to:

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA.
• Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services.
• Performs other related duties as required and assigned.

Requirements:

Education and Certifications:

• High school diploma or GED completion is required.
• A minimum of three (3) years’ experience with CPT and ICD-10 coding of physician services required.
• Coding certification required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure.
• Advanced working knowledge of medical terminology, anatomy, and physiology required.
• Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.

Experience:

• Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions.
• Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and a basic understanding of team concept.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds.
• Ability to concentrate on details.
• Use of computer for long periods of time.