Job: ABSTRACTOR/CODER-CERTIFIED

ABSTRACTOR/CODER-CERTIFIED

Requisition Number: 27884

Location: NM - Albuquerque

Type of Opportunity: Regular Full-Time

FLSA Classification: NON-EXEMPT

Minimum Experience: 1 year

Minimum Education: Technical Training with High School Degree

Shift: Days

* Establishes and monitors the process and ongoing procedures by which all in-patient and outpatient professional services provided by physicians are captured.

* Receives and monitors physician calendars and all dictation to assure that all professional services are billed.

* Receives and monitors all admitting and discharge lists and/or electronic billing and demographic information from core hospitals to assure all services are captured.

* Takes responsibility for accounts receivable by looking for lost documents to insure all encounters are coded.

* Communicate regularly with physicians and providers to assure that all services have been captured.

* Assign or affirm physician assigned correct CPT codes (and modifiers) based on the services rendered and the payer type and CMS guidelines.

* Assign or affirm physician assigned correct diagnosis code for that procedure, assure sequencing of codes.

* Maintain accurate and complete records of all work received from hospitals, outpatient surgery and physician and of work submitted for billing.

* Work with providers on a daily basis to assure that all professional services have been captured and submitted.

* Enters demographic and insurance information into the appropriate billing system.

* Research patient accounts in available computer systems and via medical records to assure that demographic and insurance information is accurate.

* Orient providers to promote understanding of process.

* Review monthly Billing system reports relative to charge postings and reimbursement.

* Review reimbursement; provide feedback to providers, modify procedures as needed to assure accurate and timely reimbursement.

* Work with business office personnel to assure timely filing of claims and accurate reimbursement.

* Prepare monthly reports for the providers relative to reimbursement and processes in place.

* Work with the PAO to assure timely filing of claims including providing needed documentation to get claims paid.

* Updates physicians of documentation and coding issues as they relate to inpatient billing.

* Post charges to the extent needed dependent upon site size and staffing.

* Performs other functions as required.

High school diploma/GED required. Must have any one of the following coding certifications at time of hire: CCS, CCA, CCS-P, CPC-A, CPC-H-A, CPC-H or CPC. One to three years experience as a coder.

Ability to process large quantities of data into succinct reports for presentation, work independently, good organizational skills and initiative. May be required to attend specialty specific training as appropriate. Tactful and professional interpersonal relationships with others. Excellent oral and written communication skills. Data entry skills; PC skills, particularly Excel, preferably Access.

Requires detailed knowledge of CPT/ICD9 coding, physician payment and reimbursement coding rules, and medical billing software in terms of what and how work is to be done as well as why it is done, this level includes interpretation of data.