Job Description

As the region's dedicated experts in exceptional musculoskeletal care, our doctors and staff at Lakeshore Bone & Joint Institute have served the orthopedic needs of northwest Indiana since 1968. With state-of-the-art facilities, we are dedicated to delivering the exceptional, compassionate care patients need to keep moving and keep enjoying their life. Under the supervision of the Billing Manager, the Certified Medical Coder will play a key role in reviewing and analyzing medical billing and coding for daily processing. They will review and accurately code office and hospital procedures for reimbursement. The employee will be responsible for performing annual coding audits of office visits, procedures, and surgeries

Essential Functions: 

• Review patient documents for accuracy to include but not limited to office visits, surgical, and non-surgical procedures.
• Ensure proper coding on provider documentation.
• Verify that all codes are current and active.
• Report missing and/or incomplete documentation to provider and/or clinical staff.
• Meet daily coding production expectations.
• Perform accurate charge entries.
• Understand coding and reimbursement regulations and recognize the order in which services are billed to ensure maximum reimbursement by reading various coding and insurance newsletters and websites.
• Accurately post services based on global services data by applying NCCI edits, AAOC, NASS and ASSH Global Guidelines for all applicable insurance carriers.
• Serve as a resource regarding insurance resolutions and coding questions.
• Communicate changes and updates in coding requirements from insurance carriers to supervisor.
• Post daily receipts and correct posting errors in practice management system.
• Assist with external and/or internal audits as requested.
• Review and make corrections based on the Missing Encounter Report.
• Audit charges provided by hospitals/surgical centers to capture all charges for posting.
• Other duties as assigned.

Education : Associates and/or Bachelor's degree preferred.

Experience : Minimum of 1-year of coding experience; orthopedic experience preferred.

• Ability to analyze situations and solve problems
• Employ Critical thinking and problem solving
• Maintains composure and operates with emotional intelligence
• Ethical reasoning and decision-making
• Strong attention to detail
• Receptive and responsive to feedback
• Excellent verbal and written communication skills
• Time management, prioritization, and sense of urgency

Physical Requirements

While performing the duties of this job, the employee may be required to sit and/or stand for prolonged periods, work longer than eight (8) hour shifts, and to work both day/evening shifts. Work may hand dexterity as well as the need to reach, climb, balance, stoop, kneel, crouch, talk, and hear. The employee must occasionally lift and/or move up to 50 lbs. While performing the responsibilities of the job, the employee is required to talk and hear. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to focus. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the job.

Environmental/Working Conditions

Work is performed in an office environment. Involves frequent personal and telephone contact with patients and with testing sites and surgery departments. Work may be stressful at times. Interaction with others is constant and interruptive. Contact involves dealing with injured sick people.

Compliance

All employees have a responsibility to comply with our organization’s policies and procedures, adhere to our Code of Conduct, complete required compliance training modules, and report any observations of non-compliance.

EEO Statement

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.

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