Physician Billing Certified Coder I

Valley Children’s Healthcare; California; On-site; USD 42,000 - 62,000; Full time

Job summary

Valley Children’s Healthcare seeks a Certified coder I to review provider documentation and perform coding functions within a professional billing workflow. Responsibilities include claim edits, claims processing, data entry, queries, and coordinating with physicians on coding issues to ensure accurate CPT assignments.

The role supports drafting letters for appeals and assists the billing manager in addressing variances between hospital and physician coding.

Qualifications

• High School Diploma/G.E.D. required.
• CPC - Certified Professional Coder - AAPC - required.
• Minimum two (2) years related experience or RHIT certificate preferred; experience with ICD-10 CM/PCS and CPT-4 coding in outpatient surgery preferred; anesthesiology coding experience preferred.

Responsibilities

• Review provider documentation and assign CPT/ICD-10 coding.
• Process claims, perform edits, rejections, and data entry tasks.
• Query physicians on documentation issues and provide coding feedback.
• Draft letters to coordinate appeals and address variances between hospital and physician coding.

Skills

CPT, ICD-10, ASA and HCPCS coding

Education

High School Diploma/G.E.D.

Job description

Job Summary:

The Certified coder I is responsible for properly reviewing provider documentation and can perform all coding functions. Possesses a solid understanding of the professional billing workflow and assists with general billing duties as necessary to include claim edits, claims processing, claim rejections, data entry, and queries and communicates with physicians on documentation issues related to code assignment and provides feedback to physicians and the physician billing entity on variances between hospital and physician CPT coding as needed. Helps identify and resolve incorrect claims issues and is responsible for drafting letters to coordinate appeals as well as other areas related to billing as assigned by the manager.

Qualifications:

Education

• High School Diploma/G.E.D. (required)

Licenses and Certifications

• CPC - Certified Professional Coder - AAPC - American Academy of Professional Coders (required)

Work Experience

• Minimum two (2) years Related experience or RHIT certificate (preferred)
• Minimum two (2) years ICD-10 CM/PCS and CPT-4 coding experience with outpatient surgery medical records. (preferred)
• Minimum one (1) year Anesthesiology coding experience (preferred)

Skills and Abilities

• Ability to work independently with limited supervision. Skilled in gathering and reporting information. Ability to multi-task and prioritize needs in order to meet timelines. Knowledge of medical terminology and anatomy. Knowledge of CPT, ICD-10, ASA and HCPCS coding.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Compensation Range:

$30.82 - $44.80

Workshift:

Position Exempt:

No

FTE %:

100

Scheduled Weekly Hours:

40

Daily Hours:

8