Coder III

The Coder III is responsible for coordinating, performing and completing Medicare compliancy. Coding consists of outpatient services in outpatient and inpatient services including procedures. To ensure coders provide technical aspects of the assignment diagnostic and carried out in accordance with established standards and in compliance NCQA and other regulatory agencies, and Tenet policy. 

Essential Duties and Responsibilities: 

Include the following. Others may be assigned. 

• Performs all assigned billing in a timely manner 
• Communicates with the physician the documentation needed to complete job functions 
• Ensures accurate coding from the medical record regarding ICD-9 and ICD-10, appropriate evaluation and management CPT code 
• Updates patient record with patient’s current insurance, address and telephone numbers 
• Identifies primary care doctor and referral source with contact information and documents it in the medical record 
• Performs claims follow up and reviews with billing agent in a timely 
• manner 
• Protects patient confidentiality according to HIPAA guidelines 
• Maintains proper credentials and researches coding issues to ensure correct coding initiative per CMS guidelines 
• Identifies and attends one course/conference per specialty, per year to continue education in the coding field 

EDUCATION / EXPERIENCE 

Include minimum education, technical training, and/or experience required to perform 

the job. 

• AA Degree required 
• Bachelors Degree preferred 
• 5 years coding experience required 
• Healthcare background is required 
• CPT current competence with ICD- 10, ICD-9, CPT-4, and HCPCS required 
• Coding scheme and reimbursement practices required 
• RHIA, RHIT, CCS, CPC or COC certification is required 
• Office, and Excel required 
• Willingness to be flexible and adaptable in a complex, matrix environment
  
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The mission of the Paley Orthopedic & Spine Institute is to provide some of the most technologically advanced treatments to improve the lives of those who suffer from congenital, developmental and post-traumatic orthopedic conditions. Serving children and adults from the local community, the United States and the world, the Paley Orthopedic & Spine Institute offers comprehensive, coordinated care from an experienced team of professionalsdesigned for the specific needs of each patient. At the Paley Orthopedic & Spine Institute, our treatment philosophy focuses on reconstruction over amputation and a commitment to preserving limbs and joints and restoring function.