The Coding & Documentation Specialist will review medical records, clinic schedules, surgery schedules and other documents and online resources to identify clinical activities that have not be submitted for billing. Follow up with the provider to obtain and complete billing information. Work with providers to address and correct problems with identification of diagnosis or procedure code, or mismatch between codes.
Job duties:
- Abstracts clinical information from a variety of medical records to assign appropriate ICD 10 CM, HCPCS and/or CPT codes to patient records.
- Reviews claim prior to submission to assure that they are complete, accurate and in compliance with coding and documentation requirements.
- Communicates effectively with providers to improve coding and assure documentation supports the codes assigned.
- Communicates with management personnel about any coding or billing matters that may place the organization or individual provider at risk of non-compliance. If necessary, takes that issue up the management chain to reach a resolution.
- In a clinic and business environment, answers questions and resolves coding and documentation issues in real time
- Keeps billing and coding knowledge accurate, complete and current and performs other duties as assigned
Minimum Qualifications:
Bachelor’s degree; or equivalent combination of education and experience.
Preferred Qualifications:
NextGen experience preferred
Pediatric and primary care coding experience preferred