Certified Medical Coder

Statement of Purpose: This position is accountable for all steps in the billing process including processing medical claim information through data-entry in the EMR, and researching and correcting data entry errors using eClinicalWorks. This position uses knowledge of CPT and ICD-10 codes to determine the appropriate order and combination of alpha, numeric or symbolic data to ensure accuracy in entering medical claim information. This position is in a primary care and behavioral health social service setting with specialized LGBTQ+ care and services. One (1) position available. This is an in office position, that can be based in either, Hillsborough, Pasco, or Pinellas county.

Primary Tasks/Responsibilities:

· Translating medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities

· Review claims data to ensure that assigned codes meet required legal and insurance rules, and that required signatures and authorizations are in place prior to submission

· Reviewing and appealing denied and unpaid claims

· Monitoring and updating patient AR balances

· Scrubbing of claims – approx. 200 claims per day.

· Tracking and updating the Aging Report and working patient accounts for accuracy.

· Manage the program for high-quality, timely coding of diagnoses and procedures for medical outpatient and Behavioral Health accounts, using ICD-10, CPT-4, and HCPCS coding classification systems, to meet billing system requirements

· Work closely with physicians, technicians, insurance companies, and other integral parties to uncover and discuss coding analysis results

· Retrieve and collect physician background info from various resources for reporting

· Analyze medical workman comp claims by identifying issues, events, diagnoses, and procedures that resulted in the action

· Prepare summaries and assign the appropriate codes that apply

· Review claims to formulate a synopsis of facts and collaborate with claims examiners regarding the synopsis as needed

· Make corrections to draft reports sent for physician review and submit approved reports to management in a timely fashion

· Interact with claims staff, attorneys, and physicians regarding reports on an as-needed basis

· Working patient collections to reduce AR as assigned

· Assisting with Front Office coverage as needed on a limited basis.

· Other duties as assigned or needed

Education/Professional:

· Minimum of 2 years of experience as a certified coder in primary care and behavioral health setting highly preferred.

· Certification as a CPC for medical practices – (HCPCS, CPT, ICD-10) Required.

· Proven experience in administrative medical information management and computer application

· Ability to work on software applications systems and a willingness to learn

Knowledge, Skills and Competencies Required:

· Knowledge of EMR systems, preferably with eClinicalWorks.

· Microsoft suite and data systems proficiency, including Electronic Medical Records.

· Ability to effectively communicate both written and verbally.

· Ability to effectively utilize problem-solving and decision-making techniques.

· Ability to make effective judgments and decisions based on objective criteria.

· Attentive to detail and strong organizational skills.

· Ability to tactfully interact with diverse personalities.

· High comfort working in a busy environment with changing priorities.

Requirements:

· Must possess and maintain valid Florida driver’s license and proof of insurance

· Must have reliable and accessible auto vehicles.

· Must pass necessary fingerprinting, Level II background checks and employment eligibility verification through the U. S. Department of Homeland Security’s E-Verify system, https://e-verify.uscis.gov/emp.