Coder - General & Laparoscopic Surgical Associates - FT Days (48774)

Job Summary:

The Physician Coder's primary responsibility is to respond to coding issues/questions and to educate physicians and physician office staff regarding the accuracy and completeness of medical record documentation, charging, coding and billing. The Coder completes worklog tasks related to coding edits of physician claims including review of documentation and communicates findings to physicians. The Physician Coder coordinates with the Chief Operating Officer and the Coder/Auditor concerning all Federal Payer coding tracking, responses, appeals and identified trends. The Coder provides federal payor coding education and identifies risks to physicians, coordinating with physician offices to identify and resolve identified billing and coding discrepancies.

The physician Coder duties include managing audits and investigations into regulatory and compliance issues and responding to requests for information from regulatory bodies.

Service and Quality Standards:

• Service

Is Customer focused

Anticipates customer needs

Adheres to customer service standards Is Competent, caring and compassionate

Treats coworkers and customers with dignity and respect Demonstrates competent, caring and compassionate behavior to customers and coworkers

• People

• Quality

• Growth

Is conversation conscious

Assures confidentiality of patient and employee information Is positive in interactions with others

Is courteous and respectful

Promotes a harassment free environment Inspires the trust of others

Acts in accordance with AMG policies and code of conduct

Is excellent in patient care and service Demonstrates multidisciplinary cooperation

Assists in obtaining excellent satisfaction scores of feedback Is safety conscious

Demonstrates safety consciousness and supports safety initiatives Is involved with improvement efforts

Supports performance improvement

Seeks ways to improve systems and services Shows commitment to improvement efforts Meets mandatory educational requirements

Is a loyal ambassador

Demonstrates commitment to AMG mission and vision Is active and involved

Supports AMG initiatives

Champions innovation and supports change Is a positive role model

Fosters team cooperation

• Finance

Is a good steward of AMG resources Develops/uses efficient work methods Is cost effective

Conserves organizational resources

Job Responsibilities:

• Completes worklog tasks related to coding edits of physician claims including review of documentation and communicates findings to physicians and practice managers.

• Completes focused audits as assigned based on federal and other third party payer identified areas of risk..

• Supports the Anderson Medical Group processes regarding appropriate and efficient interaction with audit/contractor entities specifically related to verbal and written responses and appeals.

• Completes random proactive billing and coding audits as assigned.

• Educates physician and physician office staff regarding the accuracy and completeness of medical record documentation, charging, coding and billing

• Identifies opportunities for revenue cycle and compliance improvement

• Coordinates with the physician, physician office staff and AMG leadership to identify and resolve documentation and coding issues.

• Maintains AHIMA ethical code of behavior.

• Maintains knowledge of state and federal regulation to assure accuracy of coding.

• Works with physician office staff regarding the current and ongoing revisions to NCD/LCDs to assure orders meet medical necessity requirements.

• Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid similar situations in the future.

• Responds to alleged violations of rules, regulations, policies, procedures and Code of Conduct by evaluating or recommending the initiation of investigative procedures.

• Other duties as assigned.

Qualifications

Education Requirements and Other Requirements:

Education Level: Associate; Bachelor's level preferred Certification/Licensure: RHIT; RHIA

Experience Requirements: Physician billing coding knowledge with experience related to primary care and multispecialty practices.

Working Conditions: Exposure Category III: Tasks that involve no exposure to blood, body fluids, or tissues, and Category I tasks are not a condition of employment. The normal work routine involves no exposure to blood, body fluids, or tissues. Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid.

Physical Activity:

NA 0-25% 26-75% 76-100%

Lift/Carry x

Push/Pull x

Reach Overhead x

Climb x

Squat/Bend/Kneel x

Sit x

Stand x

Walk/Move About x

The most significant duties have been included in this description. Other duties may be assigned and the AMG has the right to modify this job description as needed to accurately reflect assigned duties.