TCHP Coder Senior

Interpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures. Provide feedback and support to physicians.

KNOWLEDGE AND SKILLS:

Requires a working knowledge of Medicare regulations on charging and billing practices (UB92 and 1500/HCFA), knowledge of CPT and HCPCS coding, and the ability to read/analyze itemized billing statements, medical records, & lab reports. Critical thinking skills needed to independently conduct Opportunity Assessments in new areas of charging. Must be detailed-oriented, and have the ability to work in team environment and work toward team goals. Ability to summarize findings and present for appropriate intervention and education. Proficiency in Microsoft Office applications required. Experience with LastWord and Groupwise helpful. Ability to learn and work with “Charge Capture” software (as available in market).

EDUCATION:

Skills assessment required to determine competency level of coding skills. Certified Professional Coder (CPC) or Certified Coder Specialist-Physician (CCS-P) required

YEARS OF EXPERIENCE: 2 years coding experience required, 5 years related experience in multiple specialties preferred.

REQUIRED SKILLS AND KNOWLEDGE:

• Demonstrated in depth knowledge of HCPCS, ICD-10 and CPT coding guidelines, medical terminology, anatomy and physiology.

• Ability to accurately code diagnosis, diagnostic and surgical procedures in multiple specialties with a depth of knowledge in Evaluation and Management (E/M) coding.

• Strong knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation

• Demonstrated effective verbal and written communication skills, including with physicians and groups.

• Research skills including knowledge of automated analysis tools and on-line research tools to resolve complex coding and healthcare issues.

• Demonstrated ability to effectively work within a team environment, using excellent written, verbal, and presentation skills to share audit findings, risk areas, and compliance issues with coders, office managers, physicians, etc..

• Maintains confidentiality and protects sensitive data at all times.

LICENSES & CERTIFICATIONS:

(same as education)