Summary: Reviews and assures that all services documented in the patient’s charts are coded with appropriate CPT, HCPCS and ICD codes.
Essential duties and responsibilities include the following. Other duties may be assigned.
Assigns diagnostic and procedure codes for services and treatments documents in health records.
Works with clinics to resolve denials from the clinic denial logs.
Requests additional medical records as needed to clarify missing or inadequate medical record information required to complete the coding assessment and adhere to the documentation and billing requirements.
Make corrections as needed to ensure accurate coding, billing, and reimbursement processing.
Communicates coding results to the appropriate staff for data entry.
Maintains a working knowledge of CPT, HCPCS, and ICD coding principles,
Governmental regulations, protocols, and third-party requirements regarding billing and documentation.
Remains current on all changes in legislative regulations that impact coding.
noncompliance issues detected through to the Department Manager and Senior Director.
Complies with all policies and procedures of the Corporate Compliance Program.
Attends meetings as requested, which may necessitate working in the evening or very early morning.
Assists with special projects as assigned by the Director of Physician Coding, Documentation, and Compliance.
Works with other staff members to inspire teamwork and promote cooperation.
To perform this successfully, an individual must be able to perform each essential duty efficiently. The requirements listed below are representative of the knowledge, skill. and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.