Coder I

The Coder 1 is responsible for assigned tasks involving the creation and coding of Springfield Clinic ASC Facility, Anesthesia, and EKG encounters as well as other designated SC Physicians at outlying affiliated hospitals for submission to medical insurance or equivalent.

Job Relationships

Reports to the appropriate Coding Unit Supervisor.

Principal Responsibilities

• Access, receive and process any Anesthesia and EKG reports and encounters.
• Update insurance or patient information as appropriate for SC encounter submission.
• Access Touchworks EMR, Allscripts PM patient ledger, and hospital electronic medical records to verify surgery information, verification of testing performed, and unites billed and diagnosis information.
• Verify in Optum 360 Encoder the correct all Anesthesia Crosswalk CPT codes for billing Anesthesia claims.
• Add appropriate Anesthesia and EKG modifiers as needed for claims submission to insurance.
• Add appropriate modifiers mimicking the surgeon encounter or choosing modifiers when needed.
• May be responsible for changing the CPT and ICD-10 codes on ASC encounters to match the corresponding Surgeons CPT and ICD-10 codes located in RCX or Allscripts PM.
• Assist the insurance review team with corrections to insurance denials for all hospital EKG's.
• Stay current on all SC policies and workflow as it applies to ASC, Anesthesia, and EKG claims submission.
• Prioritize encounter submission as directed by the Coding Unit Supervisor or Manager as needed for end of month or other urgent projects.
• Communicate any CPT/ICD-10 unusual processes not previously recognized or approved.
• Correct any edits that result from coding choices that will delay claims submission.
• May be responsible for adhering to the Coding Unit standard of creating and submitting 100 EKG's per day in RCX for claim submission.
• Investigate all data received for accuracy and assist with any special projects and assignments as directed by the Coding Unit Supervisor.
• Comply with the Springfield Clinic incident reporting policy and procedures.
• Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
• Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
• Perform other job duties as assigned.

Education/Experience

• High School graduate or GED required.

Knowledge, Skills and Abilities

• Previous medical office experience or MTI graduate preferred.
• Must be able to differentiate medical chart notes, operative reports, and procedure notes.
• Medical terminology preferred, but not required.
• Must be detail oriented, organized and reliable.
• Must be able to communicate with Physician office staff, Hospital staff and Coding Unit.

Working Environment

• This job operates in a professional office environment. Routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, fax machines.

PHI/Privacy Level

HIPAA 1