Coder, Certified

Shenandoah Medical Center; Shenandoah (IA); On-site; USD 40,000 - 66,000; Full time

Job summary

Shenandoah Medical Center is seeking a medical coder to accurately code and sequence diagnoses and procedures, review documentation, and assign charge master codes to optimize reimbursement. You will use multiple systems to post charges and participate in audits to ensure accuracy.

Role requires experience in coding (ICD-10 CM/PCS, CPT-4, HCPCS), strong communication with staff and departments, and ongoing education to maintain CPC/COC/CCS/CCS-P certifications.

Qualifications

• 3-5 years: internal auditing experience preferred.
• 1-3 years: medical coding experience preferred (ICD-10 CM/PCS, CPT-4, HCPCS).
• High School or better.

Responsibilities

• Accurately codes and sequences diagnosis and procedures according to coding guidelines and abstract accurate clinical information for optimum reimbursement.
• Reviews documentation to determine the diagnosis and procedures performed.
• Assigns charge master codes, modifiers for appropriate billing and sequencing.
• Uses multiple information systems to accurately select the correct patient account to enter patient billable charges.
• Participates in audits to capture lost charges and determine accuracy of billing and coding.
• Maintains contact with staff and providers on missing or inaccurate documentation.
• Maintains contact with departments to resolve billing issues.
• Communicates with healthcare providers/compliance/coding on documentation changes to maximize reimbursement.
• Plans and promotes ongoing education to meet CPC/COC/CCS/CCS-P certification requirements.
• Follows regulatory requirements and participates in safety and quality activities.
• Keeps current with ICD-10 CM/PCS, CPT-4 and HCPCS changes and provides feedback on outdated codes.
• Organizes data to identify documentation trends for better capture of billable items.
• Performs other duties as assigned to support department objectives.

Skills

Internal auditing experience

Medical coding experience

Education

High School or better

Job description

• Accurately codes and sequences diagnosis and procedures according to coding guidelines and abstract accurate clinical information for optimum reimbursement.
• Reviews documentation to determine the diagnosis and procedures performed.
• Assigns charge master codes, modifiers for appropriate billing and sequencing.
• Uses multiple information systems to accurately select the correct patient account to enter patient billable charges.
• Participates in audits to capture lost charges and determine accuracy of billing and coding.
• Maintains active contact with staff and providers on missing or inaccurate documentation.
• Maintains active contact with departments to resolve billing issues.
• Communicates and collaborates with healthcare providers/ compliance/coding on identifying changes in documentation that may lead to maximizing reimbursement.
• Demonstrates professional growth by developing personal educational objectives to maintain coding knowledge and regulatory requirements and participating in opportunities to assure continued adherence to professional standards and the provision of highest quality care.
• Plans and implements a program for continuing self-development to meet continuing education requirements for CPC, COC, CCS, CCS-P certification.
• Demonstrates organizational skills, self-motivation and flexibility in meeting personal, professional and institutional objectives.
• Maintains current knowledge of national NCCI Coding standards of practice, JCAHO/CMS, and criteria appropriate to coding and billing.
• Maintains current knowledge of changes in ICD-10 CM/PCS, CPT-4 and HCPCS. Provide feedback and education on codes that are changed or no longer appropriate for billable items.
• Organizes data to allow for identification of documentation trends to provide feedback to staff and other healthcare providers to allow for increased capture of billable items.
• Follows policies/procedures/regulatory requirements and performs other work assignments.
• Complies with all departmental and organizational policies and procedures in addition to regulatory requirements (such as OSHA, CMS, Joint Commission, etc.)
• Participates in corporate/departmental safety and quality activities.
• Performs other duties as assigned.

Experience

Preferred

• 3 - 5 years: internal auditing experience preferred
• 1 - 3 years: medical coding experience preferred (ICD-10 CM/PCS, CPT-4, HCPCS)

Education

Required

• High School or better

Equal Opportunity Employer

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