Position Summary:
This position is responsible for coding records by established guidelines to insure appropriate reimbursement is received. Code records by the appropriate coding scheme and verifies the accuracy of the data contained within the medical record.
Essential Job Functions/ Duties
Codes records by the appropriate coding scheme utilizing approved coding guidelines.
Retrieves and sequences complications and co-morbidity's from the records to insure the most appropriate reimbursement.
Communicates with the physicians on clarification of principal and secondary diagnoses in a timely and professional manner.
Accurately, enters pertinent billing and demographic information in to the electronic medical record.
Maintains a listing of records that require diagnoses and makes any necessary changes to alleviate this. Contacts the physician offices to obtain diagnoses or clarification on diagnoses in a timely and professional manner.
Communicates with the CBO Director on coding and reimbursement issues that need to be clarified. Additionally, informs the Manager &/or Director of potential risk management issues.
Enters and accesses data appropriately in the applicable the electronic medical record.
Meets productivity standards and deadlines.
Answer telephone and complies with requests from the various customers of the Central Business Office a timely and professional manner.
Assists physicians or healthcare professionals with chart completion by pulling records upon request in a timely and professional manner.
Works closely with Central Business Office staff to address coding issues that might impact account receivables.
Work with ancillary departments to help correct inappropriate modifier usage.
Assists with other billing duties as assigned.
Behavioral Requirements
Must possess excellent interpersonal skills, a positive attitude, willingness to learn, ability to speak clearly, communicate instructions in both oral and written forms.
Demonstrate the ability to work with patients, families, physicians, mid-level providers, peers, and administrative staff in a tactful and professional manner.
All employees are required to deliver quality care by providing excellent customer service and participate within a team centered approach in the Wythe Market Physician Practices at all times.
Technical Requirements
Demonstrate knowledge of ICD-9, ICD-10, CPT codes, insurance benefits and healthcare backgrounds.
Must display proficiency in EMR, order entry and other clinic and hospital systems.
Significant working knowledge of computers, telephones, copy and fax machines.
ECW and Meditech experience preferred.
Must adhere to policies, procedures and regulations as outlined in the clinic Policy and Procedure Manual. Must possess a high degree of accuracy for the performance of job-related tasks and functions.
Degree of Supervision Required:
Must be able to work independently with minimal supervision. Must be able to prioritize and organize work areas.
V. Ages of Patients Served:
This position requires knowledge of growth and development needs of patients and families. Personnel in this position must recognize and respond to the behaviors of patients and families in each age category.
13 €“ 18 Years
19 €“ 64 Years
65 Years
VI. Working Conditions: Clinical Departments and Common Areas. Potential hazards include:
blood or body fluids
extreme conditions, hot or cold
communicable diseases
dust/fumes/ gases/odors (including asbestos)
unprotected heights
moving mechanical parts
CRT (computer) monitor
potential electrical shock
frequent, repetitive motions
x-ray electro-magnetic energy
Abuse or combative patient
high pitched noises
Other (as listed)
needles or other sharp objects
VII. Functional Requirements:
A. The employee must be able to perform medium to heavy work which may involve:
Very Frequent
Frequent lifting of 50 pounds or more.
Pushing/pulling carts, vacuum cleaners, buffers, mops, beds, furniture.
Working in wet/slippery conditions
Ascending or descending stairs using feet and legs.
Moving beds, cribs and other furniture.
Frequent stooping and/or bending in a position to assist in performance of routine duties.
Frequent kneeling or crouching to perform routine duties.
Frequent reaching with arms and grasping, holding, and picking objects with hands.
B. The employee must be able to express or exchange ideas by means of verbal communications, and be able to perceive sounds by the ear.
C. The employee must be knowledgeable of infection control standards, isolation room techniques and policy and procedure
Personal Protective Equipment: This position does require the use of personal protective equipment.
Responsibility for Confidential Data: It is the policy of the Wythe Market Physician Practices Group to ensure that the operations, activities, and affairs of our facilities and our clients are kept confidential to the greatest possible extent. Information about a patient's condition care, treatment, personal affairs, or records is confidential and may not be discussed with anyone (except those responsible for patient care and treatment) without the full consent of the patient or when compelled by legal requirements, and then only by employees having specific approval of the facilities President/CEO. If, during their employment, employees acquire confidential or proprietary information about the Wythe Physician Practices Group and its clients, such information is to be handled in strict confidence and not to be discussed with outsiders. Employees are also responsible for the internal security of such information.
In addition, employees are prohibited from engaging in securities transactions on the basis of information not available to the general public and which, if known to outsiders, might affect their investment decisions. The dissemination of such information to others who might make use of that knowledge to trade in securities is also prohibited.
Employees will be asked to sign a statement of confidentiality at the time of hire and periodically throughout their term of employment to acknowledge their awareness of, and reaffirm their commitment to, this policy.
Employees found to be violating this policy are subject to disciplinary action, up to and including termination, and may also be subject to civil and/or criminal penalties for violations of, among other things, applicable security laws.
Position Requirements:
Education: High School diploma required. Must attend educational programs to maintain the required CE hours
Experience: Must have two to three years experience within a physician office or other outpatient setting with emphasis on ICD-9-CM, CPT coding and the prospective payment system
Licensure: CPC certification required..
Special Qualifications: CPC, CEMC or advanced certification preferred.

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