Since 1969, OCR has been local and physician-owned with strong ties to the community. With a talented, hardworking and friendly staff, we all work toward the common goal of serving the residents of CO, WY, and NE with specialty-focused care. We are experiencing tremendous growth and are looking to add talented people to our team in all of our locations!
Under the direction of the Collections & Authorizations Manager, the Certified Medical Coder performs various duties to accurately interpret and bill physician charges for physician services. This position is responsible for entering appropriate Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes into Electronic Medical Records (EMR) and billing systems and accurately billing patient charges.
To perform this job successfully, an individual must have the education and experience identified below and be able to perform each essential duty and responsibility satisfactorily, either with or without a reasonable accommodation. The below is intended to describe the general content of and requirements for the performance of this job and is not to be construed as an exhaustive statement of essential functions, responsibilities or requirements.
Essential Duties and Responsibilities
- Performs initial charge review by interpreting progress notes, operative reports, discharge summaries, and charge documents to determine physician services provided and accurately assigns CPT and ICD-10 coding to Electronic Medical Records (EMR)/billing system for third party payers.
- Contacts physicians regarding procedures and other services billed to ensure proper coding. Brings any issues to manager’s attention.
- Responsible for reviewing provider surgery logs and other reports of clinical activity to ensure billing is captured for all patients.
- Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
- Works in conjunction with the reimbursement staff to answer all inquiries regarding coding and billing for physician services.
- Works in coordination with other members of the billing office as necessary.
- Participates in administrative staff meetings and attends other meetings and seminars as scheduled.
- Provides feedback on reports, decisions, and results of department in relation to established goals.
- Recommends new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed.
- Takes ownership of special projects, researches data, and follows through with detailed action plans.
- Required to follow OCR and departmental policies and procedures.
- Other duties as assigned.
Education and Experience
- High school diploma or equivalent completion is required.
- Five years’ experience with CPT/ICD-10 coding of orthopedic physician services preferred.
- Proficient knowledge of medical terminology and anatomy required.
- Working knowledge of Microsoft Office Suite or related software, billing and medical records software, and similar computer applications.
- Demonstrated knowledge of current third-party billing and collection regulatory guidelines and requirements.
Certificates, Licenses, Registrations
- Certified Professional Coder
- Oral and Written Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; writes clearly and informatively; Edits work for spelling and grammar; Able to read and interpret written information. Ability to communicate with clients or customers.
- Quality - Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality.
- Quantity - Meets productivity standards; completes work in timely manner; strives to increase productivity; works quickly.
- Detail Oriented - Consistently checks and rechecks work product for accuracy. Able to manage multiple tasks while accurately performing essential job functions. Prepares accurate and thorough reports, emails, and data as required by the position.
- Teamwork - Balances team and individual responsibilities; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
- Reasoning and Problem Solving - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
- Confidentiality - Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy. Adheres to HIPAA guidelines.
Independence of Action
Work is closely monitored by supervisor/manager; detailed instructions and procedures are generally provided.
This job has no supervisory responsibilities.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
(The phrases “occasionally”, “regularly”, and “frequently” correspond to the following definitions: “occasionally” means up to one-third of working time, “regularly” means between half and two-thirds of working time, and “frequently” means two-thirds and more of working time.)
- The work environment is the typical office environment. The employee must be able to complete their work satisfactorily in an environment where there are significant distractions, including staff, patients, and vendors walking through and conversing, telephones ringing, conversations carrying over, loud noises, and interruptions to answer questions from others.
- While performing the duties of this job, the employee is frequently required to sit and use hands to finger, handle, or feel objects, tools, or controls up to 8 hours a day. The employee frequently is required to talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms, and stoop, kneel, crouch, or crawl.
- The employee may occasionally lift and/or move up to 20 pounds and should do so in a sound and safe manner. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
- Medical, Dental, Vision coverage
- Life and AD&D Insurance
- Short Term and Long Term Disability Insurance
- Retirement savings and profit sharing plan participation
- Employee Assistance Program
- Continuing Medical Education (depending on position)
- Paid Time Off
*Benefit eligibility is dependent on employment status, and a waiting period may apply.
Orthopaedic & Spine Center of the Rockies (OCR) is an Equal Opportunity Employer and prohibits discrimination or harassment of any kind. OCR is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions are based on business needs, job requirements and individual experience and qualifications, without regard to a person's race, color, age, sex, gender identity, gender expression, marital status, sexual orientation, religion, creed, national origin, the presence of any physical or mental disability, or status as a disabled veteran, recently separated veteran, other protected veteran, or Armed Forces service medal veteran, or any other protected status.