Summary: Reviews medical record documentation to select and sequence the appropriate CPT, HCPCS, and ICD procedural coding. Participate in other coding related reviews and analysis.
Essential duties and responsibilities include the following. Other duties may be assigned.
Reviews and analyzes documentation against billed procedures
to ensure accurate
coding of diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements.
Makes corrections as needed to ensure accurate coding, billing and reimbursement processing.
Communicates with medical providers to clarify missing or inadequate medical record information required to complete the coding assessment.
Submits a daily report of coding results to the provider via the clinic coordinator.
Prepares a comprehensive report based on the findings of the documentation review for prebill
Follows the compliance plan in determining the scope and duration of the prebill
Assists the organization’s compliance officers as directed to research and investigate complaints, concerns, or questions related to the compliance issues.
Serves as a resource and liaison in the organization for coding related topics, issues, and questions.