Certified Professional Coder 3 Job in Colesville, Maryland US
Certified Professional Coder 3
TWO OPEN POSITIONS Ensures all technical aspects of the assignment of diagnostic procedure coding is carried out in accordance w/ established standards is in compliance w/ CMS, NCQA, third party payors, other regulatory agencies Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal external services. Assists supervisor in responding to coding questions from other levels of coders in responding to providers. Conducts special projects focused reviews of encounters as requested. Essential Functions: - Review code services that are potentially reimbursable, including Medicare, Medicaid, Workers Comp other third party payors by applyingcorrect coding principles. - Review code ambulatory surgical services apply coding principles for correct coding. - Respond to questions from providers through inbasket messages, coding hotline or in person as needed. - Query providers for clarification of incomplete or ambiguous documentation as appropriate monitor inbasket messages for timely responses. - Identifies workflow issues works with supervisor to address changes in process. - Serves as a regional resource to other coders health care professionals for documentation guidelines proper ICD9, CPT HCPCS level II Coding guidelines. - Works in collaboration with Coding Supervisor, Revenue Integrity Patient Financial Services to provide input on front back end errors trends that impact Revenue Cycle Enhancement. - Communicates participates in local, regional operational strategic meetings initiatives involving coding the revenue cycle enhancement process. - Participates in data quality revenue cycle validation processes on a rotating basis. - Performs other duties as assigned or required. Qualifications: Basic Qualifications: - 4 years of experience in a health care setting is required. - 3 years of coding experience is required. - 2 years of medical terminology required. - 3 years of customer service experience is required. - 3 years of knowledge in coding practices is required. - 3 years of knowledge of compliance regulatory requirements is required. - Associate's degree in health administration or RHIT certification OR equivalent years of experience is required. - CPC or CCS-P is required is required. - CPC-H or CCS is required within 6 months of employment. - Ability to work w/ maintain confidentiality of physician, patient, patient account personnel data is required. - Effective verbal written communication skills, as well as, strong interpersonal skills is required. - Ability to effectively abstract medical information to determine the correct data is required. - Strong data management skills including proficiency in MS Office applications is required. - Ability to work independently w/ minimal supervision is required. Preferred Qualifications: - Project management experience preferred. - Training/Education experience preferred. - Supervisory experience preferred.