Professional Coder Lead TMC One
Leads employees engaged in medical coding, billing, and auditing. Ensures that productivity and quality expectations are being met.
Drives process improvement and standards development.
Coordinates and implements standard work practices and methodologies for coding department.
Provides appropriate forms to billing and other departments.
Maintains department records, reports, and files as required.
Authorizes written and/or verbal inquiries to third party payers to reconcile patient accounts.
Maintains current knowledge of regulatory requirements and practices related to patient billing processes.
Ensures notification of ancillary and admitting departments of affected patient’s charges, cancellations, and/or problems, which may affect patient care quality, when necessary.
Implements CPT, ICD-10, HCPCS and other coding systems with periodic review; maintains current coding knowledge.
Adheres to TMCH organizational and department-specific safety, confidentiality, values policies and standards.
Performs related duties as assigned.
EDUCATION: Completion of a two (2) year college or an equivalent combination of relevant education and experience.
EXPERIENCE: Five (5) years of related professional record coding experience. Preferred, three (3) to four (4) years of business system analysis experience on an EPIC application.
LICENSURE OR CERTIFICATION: American Academy of Professional Coders CPC required.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of medical terminology and coding related to professional billing such as, CPT-4 codes, ICD-9, ICD-10 codes and HCPCS codes.
Knowledge of medical insurance practices and policies and regulations.
Knowledge of government and non-government uniform coding and billing guidelines.
Skill in evaluating bills/claims for payers or patients in order to collect payment in a timely manner.
Possesses and maintains knowledge of current regulatory and third party payer requirements to support billing reimbursement.
Skill in providing assistance or training to other staff members in a team environment across multiple provider specialties.
Skill in the use of computer applications and systems including: EMR, Excel, Word, Internet, email, and miscellaneous programs and networked computer systems.
Ability to read and comprehend instructions, short correspondence, and memos.
Ability to write correspondence; ability to effectively present information in one-on-one and small groups situations to customers, clients, and other employees of the organization.
Ability to read and interpret documents such as safety rules, procedure manuals, and government regulations.
Ability to effectively present information and respond to inquiries or complaints from payors, patients and/or their representatives, and the general public.
Ability to calculate figures and compute rate, ratio, and percent and to draw and interpret bar graphs; ability to apply basic algebraic concepts.
Ability to apply common sense understanding to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.