Certified Professional Coder (CPC)

Greater Boston UrologyHanover, MA
8d$28 - $31Onsite

About The Position

To support the company by providing clinical documentation and diagnostic results through proper ICD -9- CM and ICD-10-CM and CPT codes for billing. Responsible for the Company Vision “To be the prominent urology practice with a reputation for delivering excellent and effective care in all urologic modalities. By providing full-service urology to the patients and communities we serve, there will be greater satisfaction as well as patient and physician loyalty which will allow continued success and growth.” Location: This is an in-office position, no remote hours.

Requirements

  • Two years of experience working in a medical practice or in a health insurance organization
  • High school diploma or equivalent
  • Excellent verbal and written communication skills
  • Claims processing skills
  • Electronic Medical Records Experience
  • Reasoning Ability
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  • Computer Skills
  • To perform this job successfully, an individual should have thorough knowledge in computer information systems.

Responsibilities

  • Proficient in assigning accurate medical codes for diagnoses, procedures, and evaluation and management services according to the appropriate classification system for outpatient and inpatient encounters
  • Maintain knowledge of anatomy, physiology, and medical terminology commensurate with the ability to correctly code diagnoses and services
  • Review all clinical progress notes for accuracy and completeness; obtain any missing information from Providers and clinical staff members
  • Identify all chargeable items within each progress note and ensure proper CPT/HCPCS codes for each item
  • Correctly complete and submit CMS 1500 and UB04 claims daily for outpatient services as designated by CMS
  • Accurately enter all necessary modifiers on CMS 1500 claims
  • Review patient claims for demographic and coding accuracy and completeness; obtain and enter any missing demographic information
  • Assist the billing specialists in verifying and correcting coding issues per insurance requests or claim denials
  • Assist the Clinic Manager in the monthly financial closing process when necessary
  • Verify all requested medical records prior to release
  • Remediate Providers and clinical support staff
  • Maintain active Certified Professional Coder certification adherent to the most current code set for both International Classification of Disease and Current Procedural Terminology
  • Verify appropriate diagnostic and procedural coding through documentation review
  • Review billing from third party laboratories for accuracy
  • Adhere to coding guidelines and reimbursement reporting requirements
  • Ensures correct sequence correct / most accurate ICD-9/ICD-10 codes are assigned to diagnosis and procedures
  • Follow the Standards of Ethical Coding as set forth by the AAPC
  • Provide ongoing education to client practices as it relates to identified issues with coding and billing
  • Assist with claims corrections and denial resolution
  • Receives and responds to calls and notifications regarding medical record issues and orders
  • Reviews utilization of services and outcomes with administrators
  • Perform internal chart audits for documentation and coding accuracy and review encounter forms for coding accuracy
  • Willing to travel to other locations for business needs
  • Maintains strictest confidentiality
  • Performs related work as required

Benefits

  • Beyond competitive compensation, our well-rounded benefits package includes a range of comprehensive medical, dental and vision plans, HSA / FSA, 401(k) matching, an Employee Assistance Program (EAP) and more.
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