The Professional Fee Coder is responsible for accurately abstracting data into appropriate client electronic medical record systems
following the Official ICD-10-CM, CPT, and HCPCS Guidelines for Coding, AMA CPT Guidelines, Evaluation and Management Guidelines, and CMS directives.
Performs data entry of required abstracted patient information into the client’s information system.
Queries physicians when appropriate and interact with Clinical Documentation staff as per account requirements.
Maintains consistent coding accuracy rate of 95% or better while also meeting productivity standards.
Assigns appropriate ICD-10-CM, E/M, CPT, HCPCS codes and modifiers to professional fee accounts as per designated workflow.
Abstracts and enters coded data and/or charges for physician statistical and reporting requirements.
May assign/validate professional fee level of service based upon either 95 or 97 Evaluation and Management Guidelines.
Queries physicians to clarify conflicting, imprecise, incomplete, ambiguous, and/or inconsistent clinical information when appropriate.
Communicates documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution.
Communicates with Clinical Documentation Improvement and/or Revenue Cycle teams for follow up and reconciliation of accounts.
Maintains required productivity and quality requirements.
Maintains coding credential requirements.

Wound Care – Professional Fee Coder

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