Professional Coder I, PB Coding

Overview

Professional Coder I, PB Coding

40 hours per week, day shift

JOB SUMMARY:  Under direct supervision, responsible for timely and accurate coding of hospital based professional services (outpatient or inpatient hospital; single services or complete inpatient stays) by reading medical record documentation from the paper and/or electronic records.  Assigns sequence (primary, secondary, etc.) according to coding guidelines and enters into the electronic system to provide data for billing and reimbursement.

EDUCATION/EXPERIENCE:  High school diploma or GED equivalent.  One year of related coding experience. Experience in coding of physician professional services in a teaching environment and familiarity with Medicare Teaching Physician Rules preferred.

LICENSURE, CERTIFICATION, and/or REGISTRATION:  Certified Medical Coder (CPC-A, CPC, or CCS) or certification required within one year of hire date.

ESSENTIAL FUNCTIONS:
1.    Uses appropriate diagnoses codes, professional service codes and modifiers in the coding of hospital services.
2.    Maintains current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for default services and for insufficient documentation), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures.
3.    Accrues sufficient continuing education hours to maintain national coding certification. 
4.    Works collaboratively with team members and WFUP Coding Compliance Analysts to answer questions and/or resolve issues related to documentation, coding and billing of professional services. 
5.    Resolves pending charges in the TES (transaction editing system) file.
6.    Performs other related duties incidental to the work described herein.

SKILLS/QUALIFICATIONS:

• Ability to work independently and with a team in a fast-paced and high volume environment
• Emphasis on accuracy and timeliness
• Ability to perform data entry
• Ability to establish and maintain effective working relationships with staff and departments
• Solid oral and written communication skills
• Knowledge of medical terminology and human anatomy
• Excellent attention to detail 
• Strong organizational ability 
• Ability to meet and maintain departmental deadlines and performance standards

WORK ENVIRONMENT:

• Clean, well lit, office setting
• Subject to pressures or deadlines

PHYSICAL REQUIREMENTS:
0%    35%    65%        
to    to    to        
35%    65%    100%    N/A    Activity
X                Standing
X                Walking
        X        Sitting
X                Bending
        X        Reaching with arms
        X        Finger and hand dexterity
        X        Talking
        X        Hearing
        X        Seeing
                Lifting, carrying, pushing and or pulling:
X                20 lbs. maximum
X                50 lbs. maximum
X                100 lbs. maximum