A certified professional coder (CPC) is an individual of high professional integrity who has cleared a coding certification examination
Key responsibilities of a certified professional coder
A certified professional coder has knowledge and expertise in coding procedure and diagnosis used by physicians. As a CPC, you must know the correct application CPT and ICD-9 diagnosis – to translate diagnostic and procedural phrases into numerical codes used for billing and reimbursement purpose by insurance companies.
Responsibilities of a CPC are as follows:
• Code accurately: The most important task of a CPC is to determine accurate codes for physicians diagnosis and procedures.
• Being up-to-date: A CPC needs to be up-to-date with the latest medical compliance and reimbursement policies.
• Review medical records: Review medical record information to identify all appropriate coding, and see if it’s in tune with the latest reimbursement policies and CMS guidelines.
• Interface with physicians: To keep a check on compliance issues, a certified professional coder has to use her analytical skills to recommend new strategies to the physicians. Updating physicians with accurate coding information is also one of the responsibilities of a CPC.
• Implement new guidelines: A CPC must ensure that new coding guidelines are implemented in a timely manner.
• Update patient information: Patient information forms must also be updated from time to time as per requirement.
In a nutshell, a certified professional coder must demonstrate analytical and problem-solving skills regarding barriers to receiving reimbursement. Taking active part in process and quality improvement initiatives is always a plus.