About the role
Certified Professional Coder- Orthopedic Job Summary: The Certified Professional Coder performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system.
(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.