Codes and enters
office and hospital charges, procedures, performs audits, investigates coding
and billing issues, recommends corrective actions, ensures compliance with
federal and commercial coding and billing guidelines.
DUTIES &
RESPONSIBILITIES:
Codes and enters
Interventional procedures, Cardiothoracic, Vascular surgery and professional
services performed in the Hospital, ASC, and SNF services.
Reviews and corrects
billing records with inconsistent information and/or containing discrepancies.
Informs physicians and staff of corrections made.
Assists with audit
requests from government and commercial insurances.
Works with third party
software(PMD) in managing hospital services
Reviews coding
denials/edits and appeals/corrects billed charges.
Prepares reports as
requested for productivity and credentialing.
Contact physicians and
other health care professionals with questions about treatments or diagnostic
tests given to patients with regard to coding procedures.
Organizes and
participates with annual physician E&M audits.
Attends meetings and
travels to other locations as necessary.
Reviews medical
records to validate that the appropriate codes were captured and documented in
medical records ensuring compliance with HCC coding and documentation
standards.
Submit statistical
data for analysis and research by other departments.
Responds to coding and
billing questions from physicians and staff.
Informs management of
issues or concerns identified with coding and billing practices.
Provides feedback and
education to physician and professional staff regarding changes in coding
methodology.
Attends meetings and
travels to other sites as necessary.
Performs other duties
as assigned or required.
KNOWLEDGE, SKILLS
& ABILITIES:
CPC Coding and/or
equivalent certifications.
2-4 years in Medical
Coding, preferably in Cardiology, and/or Primary care.
E/M coding experience
preferred.
Prior experience in
physician billing including ICD-10, CPT medical billing, and EMR charting.
Nextgen experience a plus.
Excellent written and
oral communication skills.