General Summary - Coding Apprentice, CMG-CBO - Linthicum, Heights, MD
Under direct supervision ensures trains and observes how charges are coded appropriately from the medical record as necessary and are entered into the billing system accurately and timely. Assigns specified codes to medical diagnoses and CPT with some coding of specific surgical procedures.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
1. Analyzes and interprets patient medical records within an area of medical/clinical specialty in order to determine amount and nature of billable services.
2. Utilizes advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing, codes, in compliance with third party payer requirements.
3. Reviewing medical records and determines appropriate charges.
4. Interacts with providers and other medical professionals regarding billing and documentation policies, procedures and regulations. Obtains clarification of conflicting, ambiguous or non-specific documentation.
5. Monitors billing for optimal reimbursement while adhering to all insurer regulations regarding the prohibition of unbundling and other questionable practices.
6. Assists in working the coding denial work queue to resolution, with the primary focus of ICD-10 coding and CPT coding.
7. Attends coding conferences, workshops and in-house educational sessions to receive updated coding information, changes in coding or regulations and maintain CEU’s.
Education and Experience Required:
1. High School Diploma or equivalent (GED) is required.
2. Completion of an accredited medical coding program; including course work in anatomy, physiology, medical terminology and pathophysiology is required.
3. Must pass pre-employment coding proficiency assessment.
4. Ability to obtain a CCS-P or CPC from AHIMA or AAPC within 1 year of hire or transfer.
6 months coding, charge entry, clinical data abstraction or billing in an outpatient provider setting.
Proficiency with EPIC
IV. Knowledge, Skills and Abilities
Working knowledge of medical record practices, state and federal laws relating to release of medical information.
Working knowledge of AAPC or AHIMA coding systems, medical terminology to understand diagnoses and procedures, and the content and organization of a medical record.
Demonstrates ability to maintain applicable productivity standards level associated with the job, with less than a 3% error rate.
Demonstrated knowledge of MS Office software applications such as Microsoft Excel and Microsoft Word is required.
Ability to maintain a culture of excellent customer service, open and friendly staff relations and approachable demeanor with all levels of staff.
Effective verbal and written communication and listening skills are required to interact with various individuals seeking accounting-related information.