Certified Professional Coder

About Us: ENT Specialties, P.C. is a privately owned practice that has been providing comprehensive ENT services to all ages since 1991. As the largest Otolaryngology practice in Lincoln, we have a dedicated group of physicians, physician assistants, audiologists, nurses and staff that excel in providing the highest quality care with a compassionate touch.

Position Overview: The Certified Coder is a vital member of our team, responsible for accurately translating medical documentation into standardized codes for diagnoses, procedures, and services rendered. This role is particularly focused on coding activities within clinic and Ambulatory Surgery Center (ASC) settings. The Certified Coder ensures compliance with current coding guidelines/regulations and aids in the resolution of claim denials. The ideal candidate is an experienced professional with a keen eye for detail, a firm grasp of surgical coding guidelines, and a commitment to continuous learning and improvement.

Key Responsibilities

• Assign accurate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes to diagnoses and procedures based on thorough review of medical record documentation
• Apply coding knowledge specifically tailored to clinic and ASC settings, ensuring compliance with facility-specific guidelines and protocols
• Regularly review and stay current with surgical coding guidelines and industry standards. Provide education and updates to healthcare providers as necessary to ensure accurate and compliant coding practices
• Collaborate with surgical scheduling and prior authorization teams to ensure all coding-related aspects of patient care are accurately coordinated and documented
• Work closely with the billing team to investigate and resolve claim denials related to surgical coding. Identify common denial reasons and implement strategies to reduce future occurrences
• Assist in communicating with patients alongside other surgical team members to address questions related to coding, charge denials, and other billing issues
• Conduct thorough reviews of medical documentation to ensure completeness and accuracy. Verify that all necessary information is present to support the assigned codes
• Ensure all coding activities comply with current healthcare regulations, including HIPAA, and maintain up-to-date knowledge of changes in coding standards and payer requirements
• Provide ongoing education and feedback to healthcare providers regarding documentation practices and coding updates to improve accuracy and compliance
• Participate in quality assurance activities, including regular audits and reviews of coding accuracy and compliance. Implement corrective actions as needed to maintain high standards
• Analyze coding data to identify trends, patterns, and areas for improvement. Prepare reports for management and provide recommendations to enhance coding efficiency and accuracy

 Qualifications and Skills

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required
• Minimum of 3 years of coding experience, with a strong preference for experience in clinic and ASC settings
• Proven experience in surgical coding and familiarity with surgical guidelines and procedure
• Proficient in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding; skilled in using medical coding and EHR systems
• Excellent verbal and written skills and ability to work well with surgical scheduling, prior auth teams, billing teams, and other departments
• Up-to-date knowledge of current coding guidelines, payer regulations, industry standards and HIPAA
• Strong critical thinking skills and problem-solving with the ability to manage multiple tasks
• Excellent skills to assist patients and address their concerns professionally