Professional Services Coder
Company: Renown Health
Posted on: September 13, 2019
To be responsible for accurately assigning diagnostic and
procedural coding relative to revenue and reimbursement for all
encounters associated with Renown Health Network and Ambulatory
Services. This will also include translating patient information
into alpha-numeric medical codes using patient treatment, health
history, diagnosis, and related information. ICD-9-CM/ICD-10-CM and
CPT code assignments must be consistent with CMS Official
Guidelines and any regulatory agency guidelines.
Nature and Scope
Incumbents must be proficient with CPT and ICD coding systems and
are responsible for assigning ICD diagnosis codes and CPT procedure
codes accurately and completely to ensure optimal reimbursement and
coding quality. Coders in this position are held accountable for
adhering to coding and compliance guidelines; and accounts must be
coded and complete within timeframes specified by department
Incumbent must have skill set to:
--- Select correct code assignment by proficient analysis and
translation of diagnostic statements, physicians orders, and other
--- Code/Audit encounters within the Professional Services Coding
--- Complete accountable work related to daily unbilled charges to
ensure timely billing in conjunction with billing and compliance
--- Addresses appeals and review documentation needed for insurance
denials to facilitate expedient resolution and reimbursement.
--- Work both in a team and individual environment, and is
confident working with a wide variety of healthcare
--- Identify and resolve problems, set goals and priorities, and
represent the department in a professional manner as well as in the
absence of Leadership, as assigned.
Incumbent must be knowledgeable in Anatomy and Physiology of the
human body, Disease Pathology, and Medical Terminology in order to
understand the etiology, pathology, symptoms, signs diagnostic
studies, treatment modalities, and prognosis of diseases and
procedures performed. This position is challenged to stay abreast
of the frequent changes in Federal and State regulations for
professional fee billing and coding, stay informed of changes in
treatment modalities and new procedures codes. Job responsibilities
include accurate code assignment based on documentation and when
documentation is incomplete, vague, or ambiguous, it is the
responsibility of incumbent to work in conjunction with the
department Leadership to utilize the appropriate provider
clarification process to obtain additional information that
provides a codeable sign, symptom, or diagnosis and/or provider
order. Other responsibilities include:
--- Adherence to Professional Services Coding and Billing
--- Responsibility for maintaining coding certification and
referencing current ICD-10 coding guidelines and regulatory
--- Contacts the appropriate charging department for assistance in
obtaining physician clarification of diagnosis and/or
--- Participates in performance improvement initiatives as
KNOWLEDGE, SKILLS & ABILITIES
- Knowledge and specific details of coding conventions and use of
coding nomenclature consistent with CMS Official Guidelines for
Coding and Reporting ICD-9-CM/ICD-10-CM coding.
- Knowledge of Evaluation and Management Guidelines and auditing
in order to provide information to Auditing Team to coordinate
provider education and identify possible revenue
- Accurate translation of written diagnostic descriptions to
appropriately and accurately assign ICD-9-CM and ICD-10-CM
diagnostic codes to obtain optimal reimbursement from all payer
types, including Medicare/Medicaid, and private insurance
- Knowledge of clinical content standards.
- Ability and knowledge of the appeal process to ensure accurate
This position does not provide patient care.
The foregoing description is not intended and should not be
construed to be an exhaustive list of all responsibilities, skills
and efforts or work conditions associated with the job. It is
intended to be an accurate reflection of the general nature and
level of the job.
Requirements - Required and/or Preferred
Must have working-level knowledge of the English language,
including reading, writing and speaking English. Associates Degree
A minimum of two (2) years previous coding experience, billing for
professional services, or other related experience. Relevant
education can be substituted for experience.
Current AAPC Certified Professional Coder (CPC) certification,
AHIMA Certified Coding Specialist, Physician (CCS-P) or the ability
to obtain such certification within 90 days of hire.
Computer / Typing:
Must possess, or be able to obtain within 90 days, the computers
skills necessary to complete online learning requirements for
job-specific competencies, access online forms and policies,
complete online benefits enrollment, etc.
Keywords: Renown Health, Reno , Professional Services Coder, Other , Reno, Nevada
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