Charge Processing: Review charge documentation from the clinic and/or hospital and compares to EMR.
Accurately assign diagnosis and enter procedure codes into billing system using ICD-10-CM, CPT-4, HCPCS and other appropriate coding systems.
Perform regular auditing of coding throughout the practice, communicate findings to management, and provide recommendations based on the audit findings.
Collaboration & Communication: Communicate effectively with physicians and staff regarding correct coding and documentation processes.
Work with A/R team on follow up and resolution of coding related denials and rejections.
Reporting and Analytics: Review daily reports for coding exceptions and follow up as required.
Monitor professional publications, payer publications, and websites to remain up to date on coding changes relevant to the practice and communicate as necessary.
Continuous Improvement: Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations.
Requirements
Educational Background: High school diploma or equivalent. Certified Coder (CPC, CCS-P, or ROCC)
Experience: Minimum of 3 years of coding experience billing physician services in a healthcare setting.
Expert Industry Knowledge: Strong knowledge of Medicare, Medicaid, VA, government and commercial insurance products.
Knowledge of coding including CPT-4, HCPCS II, and ICD-10-CM.
Communication & Collaboration: Strong ability to collaborate with cross-functional teams.
Detail-Oriented: High level of accuracy, with the ability to understand and interpret clinical documentation and follow the department billing processes.
Technical skills: ARIA, MOSAIQ, and or ONCOCHART EHR system experience highly desired. Mid to advanced level use of Excel, Outlook and Word.
Adaptability and flexibility: Should be able to adapt to changes in regulations, technologies, and industry trends and adjust accordingly.