Certified Professional Coder

District Medical Group is a not-for-profit faculty practice plan with more than 650 credentialed providers who represent all the major medical and surgical specialties and subspecialties.

Responsibilities include:

• Reviewing codes submitted by physicians and other healthcare providers to assure accurate assignment of ICD-9-CM and CPT codes for inpatient/outpatient professional charges submitted via encounters, super bills and reports.
• Maintain compliance with Federal, State and payer regulations.
• Ability to review and analyze encounters, reports and other medical records to determine the appropriate diagnosis and procedure codes to describe the level of service and surgical professional services provided.
• Abstract the appropriate evaluation and management level of service from the medical record per CPT instructions.
• Understand and adhere to CPT and ICD-9-CM instructions, the appropriate use of modifiers, and multiple or add-on procedures.
• Be knowledgeable of Medicare's guidelines for Teaching Physicians and Residents and their application in the teaching environment.
• Assure healthcare provider compliance with official coding guidelines as well as DMG, Medicare and AHCCCS requirements for coding and billing.
• Identify and educate healthcare providers on additional revenue opportunities. Other tasks as assigned.

Skills/ Requirements

• A general surgery CPC with 1 year multi-specialty experience.
• Working knowledge of anatomy and the physiology of the human body.
• Working knowledge of disease processes and their relation to the procedural techniques to be coded. Knowledge in ICD-9-CM and CPT-4 coding is required.
• Customer service, problem-solving and communication skills. Able to use on-line and other resources to research.
• Moderate computer skill