Job Summary:
Working under the daily supervision of the Coding Supervisor and under the general leadership of the Revenue Cycle Management Director, the Medical Coder is responsible for accurately and appropriately coding ambulance claims in preparation for submission to the appropriate payers in a timely manner, consistent with coding guidelines and standards. This position ensures that provision of excellent patient care is extended through the patient’s billing experience.
Major Duties and Responsibilities:
- Assign accurate ICD-10 and HCPCS according to clinical documentation and official coding guidelines for ambulance services providers.
- Reviews modifiers to ensure location for origin and destination are correct.
- Monitor assigned work queues to ensure all records are processed in a timely manner, while ensuring defined productivity is met.
- Monitor the accuracy of patient demographic and insurance information.
- Validate that that required signatures are in place prior to claim submission.
- Maintain a working knowledge of insurance and/or special handling requirements as they pertain to coding for ambulance services.
- Maintain confidentiality of all patient care information to ensure patient rights are protected.
- Ensure all work adheres to all official coding guidelines and regulatory standards.
- Maintain knowledge of current industry standards and ensure organizational coding practices align.
- Understand revenue cycle key performance indicators and work to achieve the KPIs of the team.
- Maintain knowledge of current industry standards and organizational practices and work in a manner that supports a patient centered, team focused, and fiscally responsible organization.
- Communicate with other team members and leaders on identified trends and process improvement opportunities.
- Conduct self in a professional manner that reflects the mission, vision, and values of EMSA.
- Adhere to all organizational policies and work with the highest level of integrity.
- Perform other duties as assigned.
Qualification Requirements:
- Working knowledge of medical billing and medical terminology
- Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
- Ability to type at least 35 words per minute and proficiency in 10-key
- Proficiency with Microsoft Office (Word, Outlook, Excel, and PowerPoint).
- Excellent time management skills with attention to detail.
- Ability to work independently and with a group and maintain good working relationships.
Education and/or Experience:
- Medical Coding Certification, required
- Minimum GED or High School Diploma
- Minimum 2 years’ experience coding hospital or physician’s services
- Two (2) years’ experience in ICD-10, preferred
Essential Functions:
Physical Demands: Sitting for long periods of time, occasional light and moderate lifting exceeding 25 pounds. Occasional standing, walking, bending, and stooping are secondary to main elements of this position. Vision and hearing normal or correctable to within normal limits.
Working Conditions: The position works in a temperature-controlled environment with occasional exposure to extreme temperatures to include humidity. Sometimes may be exposed to fumes, grease, or oil and may experience minimal poor ventilation or air circulation. The noise level is frequently quiet with minimal exposure to moving mechanical parts/machines.
Mental/Emotional: This position is required to frequently meet deadlines, work with changing priorities, and assess the accuracy and completeness of work on a regular basis. Frequently use logic to analyze and problem solve difficult situations and communicate to express or exchange ideas using proper English grammar and spelling. Frequently utilize complex math and reasoning skills for budgeting, analysis, and risk assessment.