Certified Professional Coder
Charlestown, Massachusetts
Organization Facility: Beth Israel Lahey Health - Non Executive Category: Coding/Validation Job ID: JR63027 Date posted: 11/19/2024Job Type: Regular
Time Type: Full time
Work Shift: Day (United States of America)
FLSA Status: Non-Exempt
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
With oversight from the department Manager and exercising independent judgment within the scope of their professional practice, the Certified Professional Coder performs a variety of tasks associated with coding physician and other provider charges, and providing coding education to providers in that area.Duties include hands-on documentation review, surgical coding of physician or other qualified healthcare provider services.
Coding of inpatient and outpatient Evaluation and Management by assigning the appropriate CPT, ICD-10-CM and HCPCs codes.
Job Description:
Essential Duties & Responsibilities including but not limited to:
Coding Responsibilities:
Provides review and/or coding of any professional services including but not limited to surgeries and diagnostic services for appropriate use of CPT, ICD-10 - CM, HCPCS, and Modifier usage/linkage as well as provide ICD-10- CM coding where needed for missing diagnoses
Productivity and accuracy standards must be met according to guidelines set by manager
Prospective audit of charges entered by providers as well as provide feedback to providers
Periodic review of codes, at least annually or as introduced or required for new, revised, or deleted code updates
Answers and responds accurately and timely to questions from providers and other departments
Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding when necessary
Reports regularly on findings of reviews/rejections as required by manage
1. Physician/Provider Education:
Confers regularly with physicians/other qualified health care providers, clinical or ancillary managers, coders, or other staff through departmental staff meetings, one-on-one meetings, and/or daily interactive communication to respond to and educate providers on specific departmental and clinic wide coding issues and updates.
Participates in new physician/care provider orientation as well as provide follow-up reviews and education for the new physician/care provider if applicable for the area of responsibility.
Provides feedback, recommendations, and participates as the coding representative for the Professional Coding
Department on the Revenue Cycle Teams as requested by manager.
Develops and conducts a schedule of physician/care provider documentation reviews in areas where applicable
and/or as defined by the manager
Provides feedback to the physician/other qualified healthcare provider, Department Chair, and/or Administration as required
Documentation review is ongoing and feedback will be provided to the physician/ other qualified healthcare provider, Department Chair, and/or Administration as required
2. Education & Professional Development:
Education: High School Diploma or equivalent, plus additional specialized training associated with attainment of a
recognized Coding Certificate.
Licensure, Certification, Registration: CPC (Certified Professional Coder through American Academy of
Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information
Management Association)
3. Skills, Knowledge & Abilities:
Demonstrates a thorough understanding of the body of knowledge required for attainment of a college-level coding certificate as indicated above.
Computer skills, including word processing, spreadsheets, data entry, research, reporting, and accessing multiple hospital-wide systems.
Excellent oral and written communication skills.
Demonstrates proficiency as a teacher and/or educational resource to others in sharing knowledge and providing direction within the scope of the job.
In the absence of certain of these skills, demonstrates the ability to be thoroughly trained to meet organizational requirements.
4. Experience:
**Minimum 2 years Professional Coding experience in conjunction with requirements indicated above
5. Organizational Requirements:
Maintains strict compliance with BILH Confidentiality Policy
Incorporates BILH Guiding Principles, Mission Statement and Goals into daily activities
Complies with all BILH Policies
Complies with behavioral expectations of the department and BILH Clinic
Maintains courteous and effective interactions with colleagues and patients
Demonstrates an understanding of the job description, performance expectations, and competency assessment
Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards
Participates in departmental and/or interdepartmental quality improvement activities.
Participates in and successfully completes Mandatory Education.
Maintains minimum certification requirements for coding.
Performs all other duties as needed or directed to meet the needs of the department.