Pacific Dental Services, LLC Medical Coder in Henderson, Nevada
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The primary role of the Medical Coder is to abstract and identify the correct CPT and ICD-10 codes from various encounter forms and medical reports and file claims to insurance for reimbursement. The Medical Coder is responsible for assisting other staff with CPT and ICD-10 coding issues hindering expedient collection processes. Responsibilities include confirming modifier coding, utilizing sound professional coding judgment in establishing priority sequencing of diagnosis codes and services to assure maximum allowable reimbursement consistent with PDS Compliance Regulations, HCFA, Medicare, Commercial Insurance Carriers and all other regulatory agencies. The position assists in providing coding education and required documentation criteria to practitioners and staff and aarticipates in job-related projects.
Assigns appropriate codes for a 95% accuracy rate or better (quality standard).
Reviews chart documentation to support ICD-10 and CPT codes, and takes appropriate action if documentation is not supported by coding appropriately.
Analyzes and evaluates findings, diagnosis and procedure codes identified by physicians.
Researches CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
Files and follow s up on Third Party claims.
Utilizes Internet and other resources to research newly identified diagnosis and/or other procedures.
Answers inquiries from staff and/or clients concerning CPT and ICD-10 codes.
Prepares and performs written reports of all audits.
Maintains strict patient and physician confidentiality and follows all federal and state guidelines for release of information.
Maintains updated knowledge of coding requirements; including continuing education and certification renewal.
Maintains accurate and up to date logs of discrepancies in coding trends that negatively impact collections and presents this information and innovative resolutions to the Billing Manager.
Acts as a liaison between the CBO (Central Business Office) department, billers, and third party payers in resolving billing and reimbursement accuracy.
Other duties as assigned.
Associate’s Degree in Health Information Administration, Medical Coding, or related field from an accredited college or technical school or equivalent combination of education and/or work experience.
+2 years of related work experience in medical coding.
CPC certification is required.
Coding course work in medical terminology, anatomy, and physiology.
Prior coursework or on-the-job training in the fields of dentistry, business, or training.
Knowledge of WORD, EXCEL, POWERPOINT and QSI software applications.
Knowledge of CPT, HCPCS, ICD-10-CM, and medical record documentation requirements.
Knowledge of medical terminology, basic anatomy, physiology, and disease process.
Knowledge of Medicare and Medicaid rules and regulations.
Skills required include use of knowledge of WORD, EXCEL, and use of standard office equipment.
Demonstrate strong problem resolution skills.
Display independent judgment by willingness to make timely and accurate decisions based on available information that is sometimes vague or limited in nature.
Ability to multitask effectively and work in a fast paced and sometimes ambiguous environment, without compromising quality of work.
Ability to prioritize tasks and projects with limited direction, while understanding and contributing to the success of the organization.
Ability to read, analyze, and interpret common financial reports, and legal documents.
Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, or other members of the business community.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Strong sense of personal responsibility for tasks assigned; ability to work with others & accept direction.
Flexibility in adapting processes to meet unique needs.
Ability to communicate effectively and present information, both verbally and in writing.
Organizational ability by demonstrating a systematic approach in carrying out assignments.
Detail oriented, organized, process focused, problem solver, self-motivated proactive, customer service focused.
Ability to maintain the highest of ethical standards.
Ability to maintain strict confidence and security of all information.
Ability to demonstrate professional demeanor in personal appearance and behavior in all work related interactions inside and outside of the organization.
Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status.
Location : External NameHenderson Support Center