Monitors, reviews and applies correct coding principles to clinical information received from ambulatory areas for the purpose of reimbursement, research and compliance. Identifies and applies diagnosis codes, cot codes and modifiers as appropriately supported by the medical record in accordance with federal regulations. Ensures that billing discrepancies are held and corrected.
- Compares and reconciles daily patient schedules, census, and registration to billing and medical records documentation for accurate charge submission, which includes processing of professional charges, facility charges, manual data entry. Investigates and resolves charge errors.
- Meets coding deadlines to expedite the billing process and to facilitate data availability for CCF providers to ensure appropriate continuity of care.
- Works held claims and claim edits in the CCF claims processing system.
- Maintains proficiency in related CCF billing systems, productivity standards, and records to be used for reconciliation and charge follow up. Utilize ICD#9, ICD#10 and CPT-4 coding systems and materials.
- Maintains current knowledge and skills through reading and utilizing coding resources. Attends and participates in coding education systems.
- Other duties as assigned.
- High school diploma or equivalent.
- Specific training related to CPC procedural coding and ICD9, ICD10 diagnostic coding through continuing education programs/seminars and/or community college.
- Working knowledge of human anatomy and physiology, disease processes and demonstrated knowledge of medical terminology.
- Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS-P), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA).
- Existing CCF employees credentialed with CMC may be required to obtain CPC (or CCS-P, RHIT, or CCA) within 12 months.
Complexity of Work:
- Coding assessment relevant to the work may be required.
- Requires critical thinking and analytical skills, decisive judgment and work with minimal supervision.
- Applicant must be able to work under pressure to meet imposed deadlines and take appropriate actions.
- Minimum of two years of coding experience in a health care environment and or medical office setting required.
- Candidate must currently be employed as a Professional Fee Coder I at the Cleveland Clinic or have met all the training, quality and productivity benchmarks of Professional Fee Coder I for six months to apply for a Professional Fee Coder II position.
- Typical physical demands involve prolonged sitting and/or traveling through various locations in the hospital and dexterity to accurately operate a data entry/PC keyboard.
- Manual dexterity required to locate and lift medical charts.
- Ability to work under stress and to meet imposed deadlines.
Personal Protective Equipment:
- Follows Standard Precautions using personal protective equipment as required for procedures.
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities