This role is primarily responsible for coding procedures, diagnoses, and modifiers, ensuring accurate CPT and ICD-10 code assignments within the practice management system / electronic medical records (EMR).

Roles and Responsibilities

• Accurately code the medical records using appropriate CPT, ICD-10, and modifier codes
• Maintain compliance with medical coding standards, guidelines, and regulations
• Ensure claims are coded properly to avoid denials and ensure clean claim submission
• Meet or exceed goals and benchmarks related to accuracy and efficiency as set by the client
• Communicate effectively with internal teams to resolve any coding discrepancies
• Maintain confidentiality of all personal health information (PHI), policies, and procedures for compliance with the requirements set by the Health Insurance Portability and Accountability Act (HIPAA) protocols
• Ensure compliance with company rules and regulations, which shall include but not be limited to the Employee Code of Discipline; policies on Quality Management System (QMS), Information Security Management System (ISMS), Environment Health & Safety (EHS), and Environmental Management System (EMS); Data Privacy Act (DPA); and other duties and responsibilities prescribed for all ADEC employees
• Ensure compliance of all Non-Conformity Corrective Action Preventive Action Concessions (NCAPACs) and all other audit findings within the prescribed period
• Report security incidents and/or any identified security weaknesses
• Perform other tasks that may be assigned from time to time

Job Requirements

Education

• College graduate
• Minimum of 1 year in medical coding
• Experience with coding multi-specialty charts

Eligibility (Training, License, Certification)

• CPC, COC, or CCS or equivalent is required

Competencies (Knowledge, Skills, Attitudes)

• Strong knowledge of medical terminology, CPT coding, and ICD-10 codes

Job Factors

Technical and Professional Skills

• Proficient in the use of practice management system, EMR, and billing systems
• High level of accuracy and attention to detail
• Ability to manage multiple tasks and deadlines efficiently
• Familiarity with Microsoft Office Suite (Outlook, Word, Excel)
• Excellent communication skills and the ability to collaborate in a team environment
• Comfortable using email, web browsers, and general computer systems

Functional Competencies

• Basic technical credibility; deliver basic KPIs
• Basic results orientation and accountability; checks own work to ensure all steps are completed accurately, takes action to correct substandard work, and takes pride and ownership in one’s work
• Basic critical thinking; identifies sources of data and information and learns where to find the most relevant information for solving problems
• Basic problem solving and decision making; asks appropriate questions to define decisions to be made
• Basic organizational awareness; understands and uses the organization’s structures, rules, networks, processes, methods, or operations to achieve results
• Basic external awareness; attends training, webinars, and meetings hosted by other departments within ADEC or external organizations

Core Competencies

• Intermediate commitment to the Company’s vision and mission
• Intermediate Customer Focus, Excellence, Respect, Teamwork, Integrity, Commitment (CERTIC)
• Proficient personal awareness; identifies the strengths of others and leverages their skills (in addition to one’s own) to manage uncertain situations
• Intermediate social competence; listens actively to people’s concerns and communicates an understanding of their situation and how they feel
• Proficient communication; ensures that factual information and messages are useful, relevant, and timely; clearly presents information, probes ideas and concepts, and explains properly to facilitate mutual understanding
• Proficient collaboration; builds a collaborative environment and encourages cross-team / cross-functional cooperation when needed
• Proficient creativity and innovation; comes up with alternatives to addressing problems, some of which may require fine-tuning of what already exists