Job detail

Coder I

MyMichigan Health

#Confidentiality #Medical Terminology #Urgent Care #Microsoft Windows #Continuing Education #CPT #Epic #Fingerprinting #RHIT #CMS

Quick overview

This position is responsible for coding all services, including major and minor surgical cases performed in office and hospital settings, ensuring compliance with third-party payer guidelines for maximum reimbursement. Responsibilities include coding visits and services within 48 hours of receipt and utilizing coding guidelines to ensure clean claims.

Requirements summary

Candidates must possess broad knowledge of CPT and ICD coding rules and regulations, along with analytical skills to ensure accurate coding for timely reimbursement. A high school diploma or GED is required, though an Associate degree is preferred, and preferred experience includes two years of physician coding and billing experience.

high schoolassociate degreeprofessional certificateOrganizational SkillsConfidentialityCommunication SkillsAnalytical SkillsMedical TerminologyDecision MakingCPTCompliance MonitoringEpicCodingPayer RulesAnatomyHCPCSDocumentation ImprovementICDSurgical Case Coding

Job description

Summary

**Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered.*
This position is responsible for coding all services including major and minor surgical cases performed in both the office and hospital setting for MyMichigan Medical Group, Family Practice Center and the MyMichigan Urgent Care locations. This position monitors compliance with third party payers guidelines while ensuring the maximum allowed reimbursement is attained. This position requires broad knowledge of current payer rules for all insurance companies we participate with, in addition to analytical skills to ensure all procedures are coded correctly for a timely and accurate reimbursement from all payers. This position must be able to work independently and make decisions based on their broad knowledge of current procedure terminology (CPT) and International Classification of Diseases (ICD) coding rules and regulations.

Responsibilities

(25%)
Codes visits and services performed in both the office and hospital setting within 48 hours of receipt. (25%)
Uses the Epic coding edits, CPT Assistant, and Centers for Medicare and Medicaid Services (CMS) coding guidelines to make necessary corrections to ICD, CPT, Healthcare Common Procedure Coding Systems (HCPCS), codes, modifiers and place of service to ensure clean claims. (20%)
Codes all major and minor surgical cases, including obstetrics, performed in both the office and hospital setting, within 48 hours of receipt. (20%)
Utilizes clinical knowledge to interact with physicians/provider on a regular basis to assist in improving documentation. (10%)
Demonstrates willingness to participate in continuing education to enhance coding knowledge. OTHER DUTIES AND RESPONSIBILITIES: Reviews accounts related to patient or payer complaints/concerns. After review, responsible for timely communication to the patient, payer and physician (if needed) to address their concern. Meets established productivity guidelines. Other duties as assigned. MyMichigan Health is a technology driven organization and employees need to demonstrate competency organization in Microsoft Windows. Employees may be required to participate in further learning opportunities offered by MyMichigan Health.

Certifications and Licensures

AAPC CPC: AAPC Cert Professional Coder

Coder I

Quick overview

Requirements summary

Job description

Summary

Responsibilities

Other Information

Experience, training and skills

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