Surgical Coder

Essential Duties: (This list may not include all the duties assigned)

• Reviews operative reports and assigns andsequencesaccurate
  
  CPT codes, modifiers, and ICD-10 codes to surgical procedures.
• Enters
  
  CPT,modifier sand ICD-10 codes into the practice management software for claim submission.
• Reviews and analyzes data when insurance denies payment of surgical procedures. Ensures proper codes were submitted and files appeal letter if needed in order to receive proper reimbursement.
• Responsible for tracking appeals.
• Maintains current knowledge of relevant coding changes as they become effective and assists in implementing them.
• Answers questions from patients, clinical and billing staff.
• Maintains patient confidentiality and follows HIPAA Guidelines.
• Assists prior authorization team with needed CPT codes for upcoming surgical cases to obtain authorization.
• Assists patients with Surgical estimates.
• Performs other duties as assigned.

Qualifications:

• High School Diploma or GED.
• One year experience with CPT and ICD-10 coding in a healthcare organization preferred.
• Certified Professional Coder (CPC) required.

Skills and Abilities:

• Knowledge of medical terminology, abbreviations, techniques and procedure; and anatomy and physiology.
• Knowledge and understanding of official coding rules established by the American Medical Association (AMA) and the Center for Medicare and Medicaid Services (CMS) for assignment of procedural codes.
• Knowledge and proficiency in both CPT and ICD-10 coding.
• Knowledge of billing practices and clinic policies and procedures.
• Ability to effectively examine documents for accuracy and completeness.
• Ability to research and resolve a wide variety of problems.
• Ability to work independently and meet deadlines.
• Ability to communicate clearly both verbally and written with clinical and non-clinical staff as well as the public.