A certified professional coder (CPC) is responsible for overseeing the medical coding for healthcare agencies. Coders make sure that medical coding used is in compliance with all medical coding laws and regulations and ensure that the coding used is for reimbursable expenses when necessary. They may provide regular coding, surgical coding, or hospital coding as appropriate. Certified coders are also sometimes responsible for communicating with patients regarding rejected claims or procedures, so effective communication skills are necessary. They must also maintain confidentiality and stay current on changes to insurance coding (especially Medicare).
Certified professional coders usually work independently and report to an office supervisor or manager when necessary. They may interact with doctors, nurses, and office staffs, so good interpersonal skills are helpful. Coders usually work during regular business hours and rarely work overtime or weekends. There are no physical demands to this career, but the medical coding aspect requires a high level of repetition that can be mentally draining.
Certified professional coders must have expertise in a variety of insurance and medical coding regulations. Computer programs such as Microsoft Office Suite or Access are used often. They also must already have certification for medical coding, which can include an associate’s degree in health administration and RHIT certification. A CPC or CCS-P is a popular requirement as well. However, because medical coding can change frequently and the types of certification vary, many organizations give a coding test to ensure that the employee is a proficient coder. Years of experience in the industry can replace some of the more recent certification types.
Certified Professional Coder (CPC) Tasks
- Compile, abstract and maintain patient medical records to document condition and treatment.
- Review records for completeness, accuracy and compliance with regulations.
- Release information to persons and agencies according to regulations.
- Protect the security of medical records to ensure that confidentiality is maintained.
- Identify, compile and code patient data, using ICD-9-CM and CPT and other standard classification coding systems.