Description
Women’s Care, founded in 1998, is a leading women’s healthcare group in the United States, dedicated to providing the highest quality of care for women through their reproductive years and beyond. With 100+ locations and over 400 OB/GYNs and specialists across the country, Women’s Care provides comprehensive patient care in obstetrics, gynecology, gynecologic oncology, urogynecology, gynecologic pathology, breast surgery, genetic counseling, maternal fetal medicine, laboratory services, and fertility.
The Certified Professional Coder evaluates medical record documentation and encounter forms to ensure all charges are posted properly using accurate patient, insurance, CPT codes, modifiers and ICD 9 or 10 diagnosis codes. They provide technical guidance and training on medical coding to physicians and staff, promotes accurate documentation of services performed to ensure both compliant and optimal reimbursement.
- Check all insurance and patient information is accurate and updated prior to posting charges.
- Confirm all pre-certification, authorizations & referrals for procedures/admission & patients are obtained as needed.
- Analyzes medical record documentation and encounter from to ensure compliance and optimize reimbursement. Verify the diagnostic and procedural codes and medical documentation accurately reflect and support the visit or procedure performed. Explain discrepancies as noted to provider and management. Understand EMR E & M calculator.
- Post office visits and procedures within time period determined by management.
- Post the surgical, in-patient services, deliveries and outpatient procedures within time period as determined by manager. Ensure accurate CPT and ICD-9 or ICD-10 codes are utilized.
- Double check logs or tracking measure to verify all surgeries, deliveries, in-patient, and ambulatory procedures are posted prior to filing limits
- Discuss any questions about CPT or Diagnosis with the physician(s) or providers. Provide technical guidance in identifying and resolving issues or errors, such as incomplete or missing documentation, ambiguous or nonspecific documenting or codes that do not conform to approved coding principles or guidelines.
- Ensure compliance with established coding guidelines, third party reimbursement policies and regulatory guidelines. Review bulletins, newsletters and attends workshops provided by insurance carriers.
- Assist CBO in processing of claims by responding to claim on hold, money on hold or requests for records as needed.
- Provide support to help all claims are paid – by patient or insurance company as needed. Follow up on claims as requested and assist with appeals as needed.
- Make recommendations for changes in EMR protocols, policies and departmental procedures.
- Discuss OB or Surgery Procedures pre-pays with patients if requested.
- Respond to patient’s inquiries about insurance if needed.
- Maintain strict patient confidentiality
- Answer patients or insurance carrier questions as needed.
- Comply with closing batches for days work as outlined by management.
- Total batches/encounter forms at the end of the day and balance with the money received.
- Other duties as assigned.
- Demonstrates and embodies the Women’s Care mission and core values.
- Compliance with all HIPAA rules, regulations, and guidelines.
- Other duties as assigned.
#HP
Qualifications
Qualifications:
- Completion of medical coding program, training and certification exam.
- Possession of a CPC or COBGC though American Academy of Professional Coders (ASPC), CCA through American Health Information Management Association (AHIMA) or equivalent coding certification.
- 2 years of coding experience using ICD-9-CM and ICD-10 when required along with knowledge of CPT coding guidelines and medical terminology, state and federal CMS reimbursement guidelines.
- Must be dependable, reliable, and punctual.
WHY JOIN WOMEN'S CARE?
We Offer
- Competitive compensation package
- Health, dental, and vision benefits
- Paid time off and paid holidays
- 401k plan
- An opportunity to make a difference in patients' lives every day!
Women’s Care has grown tremendously through the years and expects to accelerate its growth with plans to expand rapidly into new markets across the U.S. With the commitment of our employees, we remain true to our mission of ‘Improving the Health of Women Every Day.’ At Women’s Care, we
CARE about our patients, and we stand by our values.
Compassion & Empathy: Treating patients like valued friends and family
Accountability: Taking responsibility for our actions and behaviors
Respect: Acting respectfully in every interaction
Excellence & Quality: Providing the safest, highest quality of care
