Pacific Dental Services
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at Pacific Dental Services
- Requisition ID
- Revenue Operations
- Location : External Name
- Henderson Support Center
The primary role of the Medical Coder is to abstract and identify the correct CPT and ICD-10 codes from various encounter forms and medical reports and file claims to insurance for reimbursement. The Medical Coder is responsible for assisting other staff with CPT and ICD-10 coding issues hindering expedient collection processes. Responsibilities include confirming modifier coding, utilizing sound professional coding judgment in establishing priority sequencing of diagnosis codes and services to assure maximum allowable reimbursement consistent with PDS Compliance Regulations, HCFA, Medicare, Commercial Insurance Carriers and all other regulatory agencies. The position assists in providing coding education and required documentation criteria to practitioners and staff and aarticipates in job-related projects.
- Assigns appropriate codes for a 95% accuracy rate or better (quality standard).
- Reviews chart documentation to support ICD-10 and CPT codes, and takes appropriate action if documentation is not supported by coding appropriately.
- Analyzes and evaluates findings, diagnosis and procedure codes identified by physicians.
- Researches CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Files and follow s up on Third Party claims.
- Utilizes Internet and other resources to research newly identified diagnosis and/or other procedures.
- Answers inquiries from staff and/or clients concerning CPT and ICD-10 codes.
- Prepares and performs written reports of all audits.
- Maintains strict patient and physician confidentiality and follows all federal and state guidelines for release of information.
- Maintains updated knowledge of coding requirements; including continuing education and certification renewal.
- Maintains accurate and up to date logs of discrepancies in coding trends that negatively impact collections and presents this information and innovative resolutions to the Billing Manager.
- Acts as a liaison between the CBO (Central Business Office) department, billers, and third party payers in resolving billing and reimbursement accuracy.
- Other duties as assigned.
- Associate’s Degree in Health Information Administration, Medical Coding, or related field from an accredited college or technical school or equivalent combination of education and/or work experience.
- +1 years of related work experience in medical coding.
- CPC certification is required.
- Coding course work in medical terminology, anatomy, and physiology.
- Prior coursework or on-the-job training in the fields of dentistry, business, or training.
- Knowledge of WORD, EXCEL, POWERPOINT and QSI software applications.
Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status.