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The Coder is responsible for accurately coding healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs. The Coder reviews medical documentation and assigns the appropriate procedure and diagnosis codes. The Coder will research inadequate documentation and rejected or denied claims to resolve issues.

• Assigns all CPT, HPCS and ICD10 codes for all services performed by providers.
• Reviews medical record documentation to identify all services provided by physicians.
• Assigns appropriate procedure codes and modifiers to accurately report the physician services provided to patients.
• Assigns appropriate diagnosis codes to accurately support the need for each physician service.
• Enters diagnosis codes and procedure codes into the EHR System.
• Identifies physician services provided. Advises director and clinicians of deficiencies to support charge capture of all billing services.
• Analyzes and resolves physician claim rejects and denials from the billing system or insurance carriers related to coding issues.
• Maintains current coding guidelines and reimbursement reporting requirements as dictated by compliance and regulatory agencies.
• Identifies trends/problems in medical documentation and recommends possible solutions and process improvement.
• Participates in ongoing physician education.
• Performs other related duties as assigned.

Summit Health ASO, provides administrative and clinical support to our full spectrum of orthopedic care services in our sub-specialty clinics, walk-in care at our OrthoQUICK clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert teams are part of the 1000+ employees who partner to provide quality services and care designed to support a healthier, more active lifestyle.

Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

Experience

• Coding Certification required (CPS, CCS or RHIT)
• 1 year(s): One year recent medical coding experience in an outpatient, clinic or hospital setting required

Education

• High School or better

Licenses & Certifications

• Certified Coder