Analyze and interpret medical
information in the medical record and assign/sequence the correct ICD-10-CM,
CPT, and/or HCPCS code to the diagnoses/procedures of office, inpatient and/or
outpatient medical records, including operative reports, according to
established coding guidelines. Knowledge of surgical coding and the
ability to review and natively code complex operative procedure reports.
In accordance with Coding Compliance team guidelines, conduct provider audits
and provide ongoing education to physicians to maximize compliance and
reimbursement. Responsible for the collection of relevant,
pertinent, accurate and timely diagnosis and/or procedural codes abstracted
from all office and hospital case types including complex medical/surgical
inpatient cases (such as neonates, pediatric cardiothoracic surgery, pediatric
neurosurgery, pediatric orthopedics, pediatric plastic surgery, pediatric
urology, general pediatric surgery and pediatric trauma services.) or other
advanced types of services including surgical, observation, outpatient, and
specialty procedures. This includes effective use of encoding and edits systems
and resources as well as recognizing what data can be abstracted, presented and
interpreted for coding and billing.. Interact with and
provide support to Billing office and facility staff to answer questions and
resolve rejected fee tickets and claims.
Employ strong understanding
of the encounter/billing process, and working knowledge of payers, as well as,
their impact on reimbursement. Utilize medical reference resources and contacts
to thoroughly research coding issues and to maintain working knowledge of
payment/reimbursement systems to ensure maximum reimbursement and coding
compliance. Identify opportunities for billing/coding improvements.
Participate in developing, implementing, and reviewing programs for coding
compliance monitoring, criteria for benchmark comparisons, organizational policies
and procedures, and physician clinical documentation improvement
programs. Meet or exceed productivity and quality standards as assigned
Take responsibility for
various projects as assigned by management and perform any additional/miscellaneous
duties (not inclusive of job description) as requested by the management team
within the scope of knowledge/ability.
Work as a team player and
communicate in a positive manner with co-workers, managers, providers, and
other contacts. Maintain patient confidentiality at all times.
Surgical Coding experience is
highly desirable. Onsite position.
Coding certification from