Coder - Compliance

Under general supervision, coordinates the processing, review and application of ICD-9 & ICD-10 coding rule sets, CPT and HCPCS codes to medical records based on documentation provided by the providers and adheres to coding compliance for a specified clinical area. Adheres to strict federal coding rules in selecting codes that appropriately and accurately reflect the condition that the patient had and the medical service that was provided. Will communicate heavily with Coding/Compliance Department and coding peers to abstract clinical and statistical data for outcome measure and monitoring. Provides coding education including but not limited to: Patient Representatives, Billing/Collection Specialists, and/or clinical providers in an effort to ensure compliance and capture appropriate revenues. Assures timely data entry for billing or auditing purposes and performs quality checks of billing information in the applicable computer system(s).

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Required qualifications:

• CEUs required to maintain CPC or RHIT certificate.

• Upon hire: National Certification from American Academy of Professional Coders Or

• Upon hire: National Certified Coding Associate

• American Health Information Management Association Or

• Upon hire: National Certified Coding Specialist

• American Health Information Management Association Or

• Upon hire: National Certified Coding Specialist

• Physician

• American Health Information Management Association Or

• Upon hire: National Certified Documentation Improvement Practitioner

• American Health Information Management Association Or

• Upon hire: National Certified Health Data Analyst

• American Health Information Management Association Or

• Upon hire: National Registered Health Information Administrator

• American Health Information Management Association Or

• Upon hire: National Registered Health Information Technician

• American Health Information Management Association

• 1 year Related to the essential functions specified.

Preferred Qualifications:

• 1 year Experience in a physician practice setting.

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