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Job Responsibility:
Reviews system edits and assigns appropriate codes from appropriate coding classification system to ensure the production of quality healthcare data and accurate professional payment
Prepares reports for designated leader(s)
Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign appropriate codes through medical record documentation as per designated workflow
Completes system edit reviews to make corrections before transmittal
Ensures work queue and responsibilities are handled within established guidelines and timeframes
Troubleshoots problems that prevent claims from being released
Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem
Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete
Prepares reports for designated leader to document recurring problems and identifies the source of reimbursement delays
Works closely with designated leader to ensure effective communication to resolve invoice payment delays
As necessary, provides Providers and other staff with information relative to coding
Responds to coding information requests and inquiries from various sources
Other duties as assigned
Requirements:
High School diploma or equivalent and less than 1 year of relevant experience required
Or equivalent combination of education and experience
Knowledge of ICD-10CM, CPT and HCPSC preferred
Working knowledge of medical terminology and anatomy preferred
American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred
Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute preferred
Nice to have:
Knowledge of ICD-10CM, CPT and HCPSC
Working knowledge of medical terminology and anatomy
American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS)
Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute