AltaPointe Health Systems Medical Coder Specialist in Mobile, Alabama
Reviews charts in the workflow on a daily basis.
Has a thorough understanding of ICD-9/ICD -10/HCPCS codes used in reimbursement and data collection.
Demonstrates ability to effectively communicate with physicians in order to clarify diagnoses, procedures coding and documentation requirements, including proper sequencing.
Ensures all charges are no more than 14 days behind from the initial date of discharge
Performs a comprehensive medical records review to assure the presence of all component part such as: patient and record identification signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Review payer responsibility guidelines.
Promptly and accurately code all services to the most accurate specificity and query providers when specificity was not indicated.
Secondary Job Functions:
Assist with all stages of the initial billing process via electronic 837’s, hard copy claims, or individual payer’s portal using the established procedures and conducting electronic remit 835 process using established procedures, when required.
Assist with reviewing outstanding claims to determine what action needs to take place and acts on claims and requesting claims to be reprocessed where necessary or prepare and submit corrected claims to the payers for payment.
Assist with correct errors including misapplied payments/adjustments and applying account credits.
Provide real-time feedback to procedural providers as it pertains to the process flow from coding to accounts receivable.
Additional Job Functions:
Education and Training
Provide education/training to physicians and other providers on coding and clinical documentation.
Consult with and educate/train physicians on coding practices and conventions in order to provide detailed coding information.
Communicate with nursing and ancillary services personnel for needed documentation for accurate coding.
Provide real-time feedback to procedural providers as it pertains to proper coding and clinical documentation of services performed.
Interacts with Managers
Interact with and provides high-level analysis of trends to Management, Managers and others about Coding related issues.
Contacts appropriate personnel for clinical documentation inefficiencies. Coordinate quality reporting measures w/ providers and revenue managers / management (PQRS).
Accepts supervision and consultation
Seeks supervision and consultation as needed
Accepts and employs suggestions for improvement
Actively works to enhance skills
Courteous and respectful towards consumers, visitors and co-workers
Treats consumers with care, dignity, compassion and respect
Respects consumers’ privacy and confidentiality
Is pleasant and cooperative with others
Assists consumers and visitors as needed
Personal values don’t inhibit ability to related and care for others
Is sensitive to the consumers’ needs, expectations and individuals differences
Is gentle and calm with consumers, families and others as appropriate
Administrative and other related duties as assigned
Actively participates in Performance Improvement activities
Actively participates in AltaPointe committees as requested
Follows AltaPointe policies and procedures
Receives and responds to inquiries of accounting matters promptly and courteously
Assists with performance of duties of other accounting staff as determined by management
Must perform all duties with the highest standard of accounting ethics
Completes assigned tasks in a timely manner
Performs other duties as assigned.
Completion of high school or equivalent. Must be a Certified Medical Coder through AHIMA or AAPC. Five years of coding experience, that includes inpatient and outpatient. Experience in coding for behavioral health. Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment for assignment of procedural codes.
Must be knowledgeable of the fiscal requirements, policies and procedures of federal and state programs.
Coding software familiarity. Strong written and verbal communication skills necessary to deal with physicians, nursing directors, department heads/directors required.
Demonstrated strength in analytical skills and problem solving skills required.
Ability to work independently
Shift/Hours (ex: Monday-Friday 8:00-4:30): Monday-Friday 8:00-4:30
External Company Name: AltaPointe Health Systems
External Company URL: http://altapointe.org/