- Assigns ICD-10-CM, outpatient CPT4, and HCPCS codes by abstracting pertinent information from patient records for both outpatient and ancillary services in primary care setting into practice management system Premier.
- Organizes, evaluates, and reviews patient electronic medical records for accuracy and completeness in final determination of E/M level of service.
- Performs data entry of coded/abstracted information into the Medical Center's computer system. Reviews all necessary edits to ensure coding compliance.
- Properly identifies patient medical coverage in order to code according to payer guidelines.
- Retrieve patient data from daily clinic and/or behavioral health schedule and using ICD-10, CPT-4, and HCPCS codes for charge creation.
- Abstract HRE relating to medical and/or behavioral health render by providers or medical staff.
- Input data into the Premier practice management system.
- Verify patient eligibility and/or coverage and identifying proper charges in accordance to the payer guidelines on electronic claim.
- Input data into current HCFA CMS-1500 and UB-04 electronic claim forms.
- Receive, review, and correct daily claims rejection reports utilizing Emdeon clearinghouse.
- Works closely with the supervisor, billing, clinical, and behavioral staff.
- Performs other duties as assigned.
Associate Degree in a medical field or the American Academy of Professional Coders’ credential and/or Certified Professional Coder (CPC); 1-2 year experience as a medical coder; or equivalent combination of education and experience sufficient to successfully perform the essential duties. Must pass background check. Possess a valid Arizona Driver License.
Knowledge, Skill and Abilities
- Knowledge of medical terminology, anatomy, and physiology advanced classes in ICD-10-CM, CPT-4, and HCPCS.
- EM leveling of charges based on documentation i.e.: HPI, Exam both 1995 and 1997 guidelines, and Medical Decision Making.
- Knowledge of HCFA-1500 and UB-04 claim format.
- Knowledge of claims scrubbing and claims clearinghouse editing features.
*Must complete and submit an NACA, Inc. Employment Application, Letter of Interest and Resume. Application can be obtained through website www.nacainc.org. Any question, please contact Human Resources at (928)526-2968.
Employer exercises EEOC and Indian preference in accordance with the Indian Preference Act (Title 25, US Code, Sections 44-46, 472 and 272). If you wish to exercise Indian Preference and you are a registered member of a federally or state recognized tribe, attach copy of tribal Certificate of Indian Blood (CIB).