Professional Coder

Department/Unit:

Work Shift:

Salary Range:

Essential Duties and Responsibilities

• Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines.
• Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes.
• Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role.
• Ensure established productivity and quality standards are met.
• Review denials, research and respond appropriately and timely.
• Perform audits as determined by management.
• Assist with all levels of application testing for identified coding workflows as needed.
• Attend and contribute to all PCO staff meetings, department meetings and all other meetings assigned.
• Assume responsibility for professional development by participating in webinars, workshops, and conferences when appropriate.
• Ability to work well with people from different disciplines with varying degrees of business and technical expertise.
• Remain knowledgeable of all insurance products (including Managed care, Medicaid and Medicare), policies and procedures as well as State and Federal mandates and legislation in relation to coding and documentation.
• Interact with providers and their staff to support accuracy and specificity in documentation and procedural and diagnostic coding.
• All other duties as assigned.

Qualifications

• High School Diploma/G.E.D. - required
• 1-3 years Experience in provider professional fee coding - preferred
• Working knowledge and experience with provider professional fee coding and charge processing. Computer experience, windows environment with proficiency in Microsoft Word and Excel is required. Excellent verbal and written communication skills. (High proficiency)
• CPC, CCA, CCS, COC, RHIT, RHIA or other coding credential through AHIMA or AAPC and be in good standing. - required

Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Lifting - Rarely
• Carrying - Rarely
• Pushing - Rarely
• Pulling - Rarely
• Climbing - Rarely
• Balancing - Rarely
• Stooping - Rarely
• Kneeling - Rarely
• Crouching - Rarely
• Crawling - Rarely
• Reaching - Rarely
• Handling - Occasionally
• Grasping - Occasionally
• Feeling - Frequently
• Talking - Frequently
• Hearing - Frequently
• Repetitive Motions - Frequently
• Eye/Hand/Foot Coordination - Frequently

Working Conditions

• Extreme cold - Rarely
• Extreme heat - Rarely
• Humidity - Rarely
• Wet - Rarely
• Noise - Occasionally
• Hazards - Rarely
• Temperature Change - Rarely
• Atmospheric Conditions - Rarely
• Vibration - Rarely

Thank you for your interest in Albany Med Health System!​

Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.