Reviews medical documentation at a proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS.
Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations an EMR and/or Computer Assisted Coding software.
Adheres to the organization and departmental guidelines, policies and protocols.
Reviews all clinician documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes.
Conduct independent research to promote knowledge of coding guidelines, regulatory policies and trends.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
Maintains the confidentiality of patient records.
Reports any perceived non-compliant practices to the coding leader or compliance officer.
Meets then exceeds departmental quality and productivity standards.
Recommend modifications to current policies and procedures as needed to coincide with government regulations.
Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable
Requirements
Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)
Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge)
Typically requires 3 years of experience in professional coding that includes experiences in either hospital or professional revenue cycle processes and health information workflows
Advanced knowledge of ICD, CPT and HCPCS coding guidelines
Advanced knowledge of medical terminology, anatomy and physiology
Intermediate computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications
Benefits
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short
and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs