Job Summary

Assigns and audits medical codes for procedures and services performed by physicians and other qualified healthcare providers in the laboratory, office, hospital or other facility letting.

This position will work remotely from the individual’s home office. Therefore, the individual must possess ability to effectively work from home remotely e.g. office space in a confidential area, adequate internet bandwidth and technical aptitude.

We operate on a 24/7/365 basis; individual may be required to work various shifts, including nights, weekends, and holidays. Schedule flexibility with and without advanced notice is required.

Essential Job Duties

• Assign accurate CPT, ICD10 and modifiers on patient charts and in the billing system
• Provide accurate answers to queries on coding
• Review all rejected claims when the rejection pertains to ICD-10, CPT or HCPCS coding
• Attends various trainings and meetings as needed.
• Performs other related tasks as directed/assigned.

EDUCATION & CERTIFICATIONS

• High School Diploma or equivalent (GED) required; college degree is a plus.
• Coder I: Active Certified Professional Coder (CPC) credential is required.
• Coder II: Active Certified Professional Coder (CPC) credential is required.
• Coder III: Active Certified Professional Coder (CPC) credential is required.

EXPERIENCE

• Minimum Required w/medical coding for professional services, CPT and ICD-10, including Anatomic Pathology and Laboratory Diagnostics:
  • Coder I: 0-2 years’ experience & intermediate level knowledge, skills and abilities.
  • Coder II: 3-4 years’ experience & intermediate level knowledge, skills and abilities.
  • Coder III: 5+ years’ experience & advanced level knowledge, skills and abilities.

KNOWLEDGE, SKILLS AND ABILITIES

• Demonstrates ability maintain confidentiality at all levels; acts with high integrity.
• Knowledge of medical coding guidelines and regulations including compliance and reimbursement.
• Knowledge of anatomy, physiology and medical terminology necessary to correctly assign diagnosis and procedures.
• Knowledge of Correct Coding Initiative edits and bundling rules
• Ability to professionally and effectively interact with clients and patients via phone
• Aptitude to maintain composure and provide outstanding service at all times; especially in stressful/difficult situations.
• Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, designing forms, and other office procedures and terminology.
• Proficient with various computer programs (including Microsoft Word, Excel, E-mail and Internet). Ability to gather data; compile information, and prepare reports.
• Establishes and maintains solid interpersonal relationships with team members across all levels of an organization.
• Demonstrates and facilitates professional communication skills; must be able to understand, listen, write and speak fluently, professionally, and, effectively in the English language.
• Motivated, responsible and organized self-starter who excels at time management, timely follow-up, meeting commitments, and, possesses a passion for continuous learning and improvement.
• Strong attention to detail, analytical, research and problem-solving skills. Pro-active ability to identify, assess, improve/refine and solve complex challenges, processes and/or situations.
• Ability to successfully work collaboratively within a team as well as independently with minimal supervision while meeting productivity goals.
• Flexible and able to thrive in a fast paced, high growth, team-based environment while successfully handling competing and ever-changing priorities and responsibilities with frequent interruptions.
• Solid track record of taking responsibility and holding one’s self accountable for high quality task deliverables within established deadlines.
• Effective facilitation, collaboration, negotiation and conflict resolution abilities.
• Exhibit personal presentation in a professional manner as it relates to appearance, communication and actions.
• Regular and predictable attendance and punctuality.
• Focused on overall NWP team success vs. solely on individual success.

Working Conditions

• We share a collaborative obligation to ensure that we conduct ourselves in the utmost ethical manner and that we hold each other accountable to the values and standards of the organization. Every employee has the responsibility to ask questions, seek guidance, and report concerns and/or violations of company policy or ethical standards.
• The organization has several processes in place to communicate with leadership and expects that employees will have a commitment to integrity and uncompromising values.
• Work is performed in a fast–paced office environment with frequent interruptions.
• This job generally operates in a professional office environment. This role routinely uses standard office equipment such as computers/keyboards/mice, printers, phones, mobile devices, photocopiers, filing cabinets, fax machines, etc. The noise level in the office work environment varies from moderate to loud.

Physical Requirements

• Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
• While performing the duties of this job, the employee is regularly required to talk or hear; sit; stand; walk; use hands to finger, handle or feel; grasp and/or reach with hands and arms; repetitive movements of the wrists, hands and/or fingers.
• Specific vision abilities required by this job include close visual acuity and ability to adjust focus to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing computer monitor(s); extensive reading; and legally operate a motor vehicle.

The statements contained herein reflect general details as necessary to describe the principal functions of this job, the level of knowledge and skill typically required and the scope of responsibility, but should not be considered an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise to balance the workload. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.