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Responsible for office, out-patient, and inpatient physician coding. Provides education regarding documentation requirements for improved quality of coding and to ensure accurate and complete capture of revenue.
Duties and Responsibilities ____________
1. Responsible for performing specialty coding for services and medical office visits.
2. Validates and determines appropriate coding levels by obtaining and reviewing clinical documentation.
3. Compares and reviews charge tickets, both manually and system generated, to clinical documentation to ensure that all charges for procedures and pharmacy items have been accurately documented and captured.
4. Ensures that documentation supports charges to prevent denials/underpayments.
5. Follows-up on missing charge tickets and clinical documentation as appropriate
6. Assist with implementation of documentation and revenue enhancement opportunities.
7. Collaborates with clinical staff to identify and implement appropriate documentation and coding modifications.
8. Reviews and distributes coding related information to clinical staff, including CPT and ICD-9 code changes, medical necessity policies, coding /billing information regarding new procedures and pharmacy items.
9. In conjunction with Sr. Billing Analyst, identify relevant charge master or fee updates.
10. Responsible for resolving any coding related errors and denials that are identified by Hospital or Practice billing system as part of the revenue enhancement initiatives.
11. Consults and provides feedback with frontline clinical staff and financial coordinators to identify reimbursable indications for treatment.
12. Assists on reviews of revenue cycle with management and supervisor.
13. Participates in education programs to maintain up to date coding skills.
14. Participates with the Compliance Department in random chart audits to ensure appropriate documentation, coding and billing.
Associates degree or HS Diploma/GED plus two years of related experience.
Experience Requirements __________________
Two years of experience in medical practice or outpatient coding.
Medical practice business office or patient accounts experience a plus.