Certified Professional Coder

Overview

A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements.

Responsibilities

• Coding and Abstracting: Accurately translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS).
• Documentation Review: Analyze patient records for completeness, accuracy, and compliance with coding guidelines.
• Reimbursement Analysis: Research and analyze data needs for accurate and timely reimbursement.
• Auditing and Compliance: Conduct chart audits, identify coding discrepancies, and implement corrective actions.
• Communication and Collaboration: Communicate effectively with healthcare providers to clarify coding issues and ensure accurate documentation.
• Staying Updated: Keep abreast of changes in coding guidelines, regulations, and technology.

Qualifications

Qualifications:

• Education:
• Certified Professional Coder (CPC) or Certified Coding Specialist Physician Based (CCS-P) or Certified Radiology Coder (RCC) is required.
• Experience:
• Prior experience doing physician/provider professional fee billing is preferred.
• Skills and Abilities:
• Coding Knowledge: Strong understanding of coding systems (ICD-10, CPT, and HCPCS), coding guidelines, and relevant regulations.
• Attention to Detail: Ability to meticulously review documentation and accurately assign codes.
• Communication Skills: Effectively communicate with healthcare providers, billing staff, and other stakeholders.
• Problem Solving: Ability to identify and resolve coding discrepancies and errors.
• Organizational Skills: Maintain accurate records, manage workload effectively, and prioritize tasks.
• Computer Skills: Proficiency in using coding software and electronic health records (EHR) systems.
• Courier Route: Must be able to use personal transportation to provide courier services for the office.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

WORKING CONDITIONS

Physical presence onsite is essential with possibility of hybrid work schedule. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.

Valid driver’s license and automobile liability insurance. Very good interpersonal communication and customer service skills required.

Physical: Medium work – Exerting 20 – 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to more objects. Physical Demand requirements are in excess of those for Light Work. Good manual and finger dexterity. Ability to tolerate prolonged periods of sitting. Some light driving required.

Psychological: Contact with Others, Deal with external customers/clients, sometimes dealing with unpleasant people, occasionally coordinating letters/memos, working with work groups or as a Team constantly/consistently.