Certified Coder II
Methodist Health System Omaha, NE
Purpose of Job
Codes professional charges and/or hospital services to ensure accurate billing. 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.
Not necessary for the position (0%):
Occasionally Performed (1%-33%):
Frequently Performed (34%-66%):
Constantly Performed (67%-100%):
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)
Explosives (pressurized gas)
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 dictation and assigning CPT and ICD-10-CM codes following CPT coding and 1997/1997 E/M guidelines including clinic encounters, minor clinic procedures, professional inpatient and outpatient initial and subsequent hospital visits, or ED encounters.
Ensures timely submission of claims to insurance companies by performing job functions #1 by maintaining Accounts Receivable within 3 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.
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.
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.
Reviews Medicare and Commercial correspondence for updates by checking for billing and coding changes. Updates coding manual when necessary.
Reviews Current Procedural Terminology (CPT) procedure codes in the code summary and charge viewer 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.
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.
| Date Posted
February 14, 2020
| Date Closes
April 14, 2020
| Located In
| SOC Category