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Certified Coder I

Methodist Health System Omaha, NE

Job Description

  • Purpose of Job
    • Reviews Current Procedural Terminology (CPT) procedure codes and CPT charge codes to ensure all accounts reflect appropriate charges for services provided by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account.
  • Job Requirements
    • Education
      • High School Diploma or General Educational Development (G.E.D) required
      • College level completion of courses in anatomy and physiology, biology, disease process, and medical terminology required.
      • Associate's Degree in Health Information Management or healthcare related degree preferred.
      • Participates in mandatory in-services and continuing education as mandated by policies and procedures, external agencies, and as directed by supervisor.

    • Experience
      • Prior healthcare registration, customer service, insurance or billing experience preferred.

    • License/Certifications
      • Certification as Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) or registration as Registered Health Information Tech (RHIT) required.

    • Skills/Knowledge/Abilities
      • N/A
  • Physical Requirements
    • Weight Demands
      • Light Work - Exerting up to 20 pounds of force.

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

    • Job Hazards
      • Not Related:
        • Chemical agents (Toxic, Corrosive, Flammable, Latex)
        • Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (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
  • Essential Job Functions
    • Essential Functions I

      • Codes professional charges and/or hospital services to ensure accurate billing by reviewing doctor dictation and assigning CPT and ICD-10- CM codes.

      • Ensures timely submission of claims to insurance companies by performing job functions #1 by maintaining Accounts Receivable within 3 - 5 days of discharge on all outpatient encounters. Maintains a minimum productivity standard of:
        • Codes 30 Radiology/OP Diagnostic services encounters per hour.

        • Codes 25 Non-patient Pathology Encounters per hour.

        • Codes 15 Recurring encounters per hour.
        • Codes 15 Emergency Department encounters per hour.
        • Codes 12 Professional Services encounters per hour.
        • Codes 10 GI Lab and Pain Management encounters per hour.

      • Assigns appropriate E/M Current Procedural Terminology (CPT) code into the coding abstract following CPT coding and 1995/1997 E/M guidelines on Clinic encounters, Professional inpatient initial and subsequent hospital visits, or ED encounters.

      • Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates.

      • Investigates claim denials from third party payers to ensure accuracy by reviewing services patient received and patient account and making any coding/charging corrections.

      • Reviews Medicare and Commercial correspondence for updates by checking for billing and coding changes. Updates coding manual when necessary.

    • 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 February 14, 2020
Date Closes April 14, 2020
Requisition 14496
Located In Omaha, NE
SOC Category 00-0000.00