Professional Services Coder III
Company: Taylorville Memorial Hospital
Posted on: August 6, 2022
Provides documentation review, coding and billing services to in
accordance with DMG's compliance plan, following its policies and
procedures, official and regulatory coding guidance. Understanding
and accurate use of approved coding guidelines is paramount to
successful performance in this position.
Education and/or Other Requirements
* Minimum High School Diploma or equivalency. College degree and /
or extended education in an allied health field preferred.
* Possess an established coding credential from AAPC (CPC) or AHIMA
(CCS-P) or Certified Professional Coder - Apprentice, pertaining to
professional fee coding and remain in good ethical standing, by
obtaining the necessary continuing educational certification
* Five (5) or more years' experience in healthcare billing, coding
and / or reimbursement follow up activities for professional coding
To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and/or ability
* Knowledge of ICD-10-CM and CPT/HCPCS coding systems.
* Knowledge of medical terminology, pharmacology, pathophysiology
and Anatomy and Physiology.
* Understanding of medical records content, format and other
* Knowledge of pertinent reimbursement systems, including but not
limited to Medicare and Medicaid Physician Fee Schedule and RBRVU
* Knowledge of EMR systems and the ability to learn the DMH / DMG
EMR system(s) efficiently.
* Knowledge of encoder software tools for professional
* Knowledge of CMS Guidelines including but not limited to NCCI
policy manuals, LCD/NCD policies etc.
* Possess basic PC skills, including ability to work with MS Word
* Thoroughness and attention to detail.
Occasional exposure to moderate environmental variations,
above-normal noise levels, and/or unpleasant substances. Exposure
to hazardous or potentially injurious elements or conditions is
The physical demands described are representative of those that
must be met by an employee to successfully perform the essential
functions of this job.
* Extensive use of keyboard, monitor and mouse.
* Occasional business-related travel might be required.
* Little or no physical effort or strenuous activity other than
incidental walking, standing, bending and reaching and carrying of
light loads (1 to 5 pounds).
* Analyze information or data.
* Ability to adjust to performing routine and repetitive tasks
without specific supervision.
* Ability to understand and relate to the concepts behind specific
ideas and remember multiple tasks given to self and others over
long periods of time.
* Comprehend written basic instructions, and office memoranda.
* Ability to adhere to strict confidentiality requirements.
* Ability to communicate in oral and written form using high level
* Identifies and assigns appropriate codes for the purpose of
reimbursement, research, and compliance in accordance with ICD-10
and CPT coding guidelines.
* Reviews all professional services encounters and assigns and
sequences all diagnoses and procedure codes to the highest level of
specificity documented in the provider notes.
* Accurately assign Evaluation & Management ("E/M") services after
review of the provider's documentation in accordance with the 1995
or 1997 E/M documentation guidelines.
* Assign ICD-10-CM, CPT / HCPCS coding and modifiers for
* Complies with all federal, local and other legal requirements as
they relate to medical coding practices.
* Observes confidentiality and safeguards all patient related
* Follow CMS Guidance including but not limited to NCCI policy
manuals, LCD / NCD policies etc.
* Understand and follow DMG specific coding requirements.
* Complete coding tasks while maintaining the required accuracy and
* Utilize DMMG's Epic electronic health record ("EHR") and other
DMMG and DMH documentation and billing systems to abstract and code
all professional services, including data entry of codes.
* Use professional services encoder software to determine RVU
values for correct coding assignment and modifier use.
* Participate in DMMG's coding quality reviews as deemed
appropriate by the HIM Director.
* Attend continuing education classes to maintain coding credential
and continually improve proficiency in areas of coding that include
but are not limited to CPT, ambulatory surgery, surgical
specialties, E/M assignment, ICD-10-CM and other specialties as
* Interpret coding rules and general policies in addition to
determining appropriate conclusions.
* Complete administrative activities such as time reporting,
productivity reporting and expense reporting as necessary and in
accordance with established policies and deadlines.
* Communicates in a positive and professional manner with visitors,
physicians, and hospital staff.
* Perform other job-related duties as required.
Keywords: Taylorville Memorial Hospital, Decatur , Professional Services Coder III, Other , Decatur, Illinois
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