Certified Professional Coder

Essential Functions

  • Consistently exhibits behavior and communication skills that demonstrates Tandigm’s commitment to superior customer service, including quality, care and concern with each internal and external customer.
  • Performs quarterly audits of clinical documentation by assessing the level and accuracy of coding and documentation of ICD-10 codes using Tandigm’s auditing criteria.
  • Assists with acquiring visit notes required for audit.
  • Serves as a key contact and liaison with clinicians to answer coding questions.
  • Conducts individualized training sessions with clinicians and their staff around specific coding issues based on audit results.
  • Proactively disseminates coding updates to the clinicians.
  • Works with key departments within Tandigm to review and explain medical chart audit results.
  • Brings questions to the ACE Medical Director as needed.
  • Assists in training incoming department staff.
  • Supports and participates in process and quality improvement initiatives.
  • Stays abreast of industry coding and compliance issues.
  • Participates in coding / auditing discussions to ensure best practice efforts and processes are implemented through appropriate coding.
  • Ability to travel throughout the five county Philadelphia region (Bucks, Berks, Montgomery, Delaware, & Chester) to Primary Care Practices (PCPs) as needed.
  • Performs additional duties as assigned.
  • Uses, protects, and discloses Tandigm’s patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Performs additional duties as assigned.

Education

  • High school diploma or equivalent required, some college education a plus;
  • Current/active coder certification is required by the AAPC, (CPC designation).

Experience

  • 4 to 6 years of coding experience required with emphasis on ICD-10, CPT and HCPCS coding, medical terminology and regulatory requirements
  • 2 years Coding Training experience.
  • 2 years of medical chart auditing experience preferred.
  • Prior work experience in the healthcare field specifically related to coding and/or medical billing and compliance

 

Licenses/Certifications

  • Medical Coding Certificate CPC Credential/Certification by AHIMA or AAPC.
  • Must have valid PA driver’s license; proof of liability and property damage insurance on vehicle used is required.
  • Must be able to travel throughout the five county Philadelphia (Philadelphia, Chester, Berks, Delaware, Bucks) region as needed.

Knowledge, Skills, & Abilities

  • Demonstrated knowledge of ICD-9, ICD-10, HCPCS and CPT coding guidelines, medical terminology, anatomy and physiology.
  • Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate ACE information.
  • Computer literate with medical billing software.
  • Proficient in Word, Excel, PowerPoint,
  • Knowledge of CMS coding guidelines, including understanding of ACE/RAF.
  • Excellent verbal and written communication skills in the English language.
  • Must be able to work independently to carry out work efforts.
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