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Eval &Mgt/Diagnostic Coder

Methodist Health System Omaha, NE
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Job Description

  • Purpose of Job
    • Codes clinic charges and/or hospital services to ensure accurate billing.
  • Job Requirements
    • Education
      • College level completion of courses in Anatomy & Physiology, Biology, Disease Process and Medical Terminology required.
      • Health Information Management Degree or associated healthcare degree (Certified Professional Coder or Certified Professional Coder-Hospital or Registered Health Information Tech or Registered Health Info Administration) preferred or willingness to pursue education and obtain minimal credentials within 1 year of hire. ICD-10 certified or in the process of actively pursuing education and credentials.

    • Experience
      • 1+ years of previous experience coding physician office services (not from documentation)
      • Or
      • 4 to 5 years of previous experience in physician billing/insurance follow up required.
      • Or
      • Candidates enrolled in an approved coding program may be considered for this entry level position with little or no hands on experience and allowed to gain experience via on the job training.

    • License/Certifications
      • Certified Professional Coder (CPC) or Certified Professional Coder-Hospital (CPC-H) or Registered Health Information Tech (RHIT) or Registered Health Information Adminitrator (RHIA) preferred.

    • Skills/Knowledge/Abilities
      • Ability to demonstrate a comprehensive understanding of Current Procedural Terminology, Healthcare Common Procedure Coding System and ICD-10 coding required.
      • Able to score of 80% or better must be obtained on test of above areas required.
  • Physical Requirements
    • Weight Demands
      • Sedentary Work - Exerting up to 10 pounds of force. Sitting most of the time. Walking and Standing are required only occasionally.

    • Physical Activity
      • Not neccessary for the position (0%):
        • Climbing
        • Crawling
        • Kneeling
      • Occasionally Performed (1%-33%):
        • Balancing
        • Carrying
        • Crouching
        • Distinguish colors
        • Lifting
        • Standing
        • Stooping/bending
        • Twisting
        • Walking
      • Frequently Performed (34%-66%):
        • Grasping
        • Pulling/Pushing
        • Reaching
        • Repetitive Motions
        • Speaking/talking
      • Constantly Performed (67%-100%):
        • Fingering/Touching
        • Hearing
        • Keyboarding/typing
        • Seeing/Visual
        • Sitting

    • Job Hazards
      • Not Related:
        • Chemical agents (Toxic, Corrosive, Flammable, Latex)
        • Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) Blood or Body Fluid (BBF)
        • Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)
        • Equipment/Machinery/Tools
        • Explosives (pressurized gas)
        • Electrical Shock/Static
        • Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc)
        • Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
        • Mechanical moving parts/vibrations
      • Note: Safety Officer can assist with identification of job hazards
  • Essential Job Functions
    • Essential Functions I


      • Codes clinic charges and/or hospital services to ensure accurate billing by reviewing doctor dictation and assigning CPT and ICD-10 codes.
        • Accurately code billing 98% of the time.
        • Hospital coding staff maintains productivity within 5 days of discharge.
        • Office coding staff maintains no more than 2 days worth of charges at work station at any given time.
        • Semi-annual audit performed on submitted work

      • Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates.
        • Review coding with Physicians 98% of the time.
        • Per departmental audit standards
        • Per provider request

      • Assists patients and third party payers to facilitate customer service by answering questions/concerns regarding coding and billing.
        • Per department process regarding code reviews within 14 days of receipt
        • Per request from clinic personnel
        • Per request from Business Office and/or Customer Service Personnel

      • Investigates claim denials from third party payers to ensure accuracy by reviewing services patient received and patient account and making any coding/charging corrections.
        • Per department process regarding code reviews and/or denials within 14 days of receipt
        • Per request from clinic personnel
        • Per request from Business Office and/or Customer Service Personnel

      • Reviews Medicare and Commercial correspondence for updates by checking for billing and coding changes. Updates coding manual when necessary.
        • As defined by Administrator of Support Services

      • Prepares delinquent provider reports for supervisor by maintaining daily productivity sheets, ensuring documentation is completed with charge ticket submission and codes using appropriate CDM codes as defined by Delinquent Provider Policy.
        • As defined by Administrator of Support Services

    • Essential Functions II


      • Participates in mandatory in-services and/or CE programs as mandated by policies and procedures/external agencies and as directed by management.

      • Follows and understands the mission, vision, core values, Employee Standards of Behavior and company policies/procedures.

      • Other duties as assigned.










Job Details

Date Posted May 8, 2018
Date Closes July 7, 2018
Requisition 8756
Located In Omaha, NE
Work At Physicians Clinic Inc
Department Coders
Shift Daytime
Hours 8-4:30 hours per week
SOC Category 00-0000.00
Location