Certified Coder

Somatus

Somatus

Software Engineering
Virginia, USA · McLean, VA, USA · United States
Posted on Sunday, June 23, 2024
Overview

As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home.

It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you?

Showing Up Somatus Strong

We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make:

  • Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say.
  • Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more.
  • Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests.
  • Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions.
  • Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners.

Showing Up for You

We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including:

  • Subsidized, personal healthcare coverage (medical, dental vision)
  • Flexible PTO
  • Professional Development, CEU, and Tuition Reimbursement
  • Curated Wellness Benefits supporting teammates physical and mental well-being
  • Community engagement opportunities
  • And more!

The Certified Professional Coder will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. The Certified Professional Coder will be responsible for reviewing physician/non-physician documentation, accurately assigning CPT, ICD-10-CM and HCPCS Level II codes, and ensuring compliance with coding guidelines and regulations. Attention to detail, time management, and a high-level of customer service skills are required. We are looking for a positive team player with a strong work ethic and good attendance history. This full-time position reports to the Sr Coding Manager.

This role requires you to be on-site at our headquarters in McLean, VA.


Responsibilities

  • Review and analyze medical records to identify and extract relevant diagnoses, procedures, and services for accurate coding.
  • Assign appropriate diagnosis codes (ICD-10-CM) and procedure codes (CPT/HCPCS) based upon medical documentation.
  • Verify and ensure that all codes are accurately applied and comply with coding guidelines and regulations.
  • Review and resolve coding-related denials, discrepancies, and inquiries.
  • Assist physician/providers with questions regarding coding and documentation guidelines.
  • Provides ongoing feedback based on observations from coding physician/provider documentation.
  • Identifies opportunities for education and communicates trends to Manager.
  • Review and resolve charge sessions that fail charge review edits, claim edits, and follow-up denials.
  • Manage assigned charge reviews, claim edits, and coding follow-up work queues.
  • Monitors charges and codes for appropriateness of modifiers in relation to NCCI/CCI edits and payer specific requirements.
  • Stay updated with the latest coding guidelines, regulations, and industry changes.
  • Maintain confidentiality and always adhere to HIPPA regulations.
  • Perform other duties and projects as assigned.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.


Qualifications

  • Current Certification as a Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist – Physician (CCS-P) from AHIMA.
  • A minimum of three years’ experience in the outpatient setting (physician’s office or ambulatory surgery centers) including assignment of E&M, CPT, and HCPCS codes.
  • Strong understanding of anatomy, physiology, and medical terminology required.
  • Ability to work independently and in a team environment.
  • Effective communication skills: both written and verbal.
  • Detail-oriented with high accuracy in coding and data entry.
  • Ability to maintain benchmarks such as production and low error rate.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.