Certified Coder I

Methodist Physicians Clinic


Reviews Current Procedural Terminology (CPT) and CPT charge codes to ensure all accounts reflect appropriate charges for services provider by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account.

Job Description:

  • Codes professional charges and/or hospital services to ensure accurate billing by reviewing doctor dictation and assigning CPT and ICD-1–cm codes
  • Ensures timely submission of claims to insurance companies by performing above and by maintaining Accounts Receivables with 3-5 days of discharge on all outpatient encounters. Maintains a minimum productivity standard of:
    • Codes 30 Radiology/OP Diagnostic services encounters per hour
    • Code 25 Non-patient pathology encounters per hour
    • Codes 15 Recurring encounter per hour
    • Codes 15 Emergency Department encounters per hour
    • Codes 12 Professional Services encounters per hour
    • Codes 10 GI Lab and Pain Management encounters per hour
  • Assigns appropriate E/M Current Procedural Terminology (CPT) code into the coding abstract following CPT coding and 1995-1997 E/M guidelines on Clinic encounters, Professional Inpatient Initial and subsequent hospital visits, or ED encounters
  • Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates
  • Investigates claim denials from third-party payers to ensure accuracy by reviewing services patient received and patient accounts and making any coding/charging corrections
  • Reviews Medicare and Commercial correspondence for updates by checking for billing and coding charges. Updates coding manual when necessary
  • Participates in mandatory in-services and/or CE programs as mandated by policies and procedures/external agencies and as directed by management
  • Follows and understand the mission, vision, core values, Employee Standards of Behavior and company policies/procedures
  • Other duties as assigned

Required Qualifications:

Certification as a Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) or registration as Registered Health Information Tech (RHIT)

Preferred Qualifications:

Prior healthcare registration, customer service, insurance or billing experience preferred.

Education Qualifications:

  • High School Diploma or General Educational Development (G.E.D) required
  • College-level completion of course in anatomy and physiology, biology, disease process, and medical terminology required.
  • Associate’s Degree in Health Information Management or healthcare-related degree preferred

Instructions for Resume Submission:

Apply Online: https://pm.healthcaresource.com/cs/methodisths/#/job/21803