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Certified Surgical Coder preferably with ENT knowledge. Must have experience in surgical coding. Knowledgeable in charge posting, modifiers, diagnosis, and coding surgeries. Coding Certificate must be active. This posistin monitors and reviews all medical records in order to assure the accuracy of medical coding, including appropriate completion and documentation of physician signatures, and proper coding of diagnoses and procedures. Thorough understanding of CMS/Medicare regulations, as well as technical knowledge of the International Classification of Disease (ICD-10) and Current Procedural Terminology (CPT-4) classification systems.
This position will be responsible for obtaining complete and accurate patient demographic information for orderly registration of pediatric, adult, and geriatric patients. Perform registration, admission, pre-admission, reception and discharge functions for all patients having services rendered. Collects and distributes patient information, billing information, and patient collection information. Provides financial estimates and collects applicable patient financial liability. Makes the patient aware of the practice’s policies and procedures. Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining superior service excellence. The duties of this position require the exercise of courtesy in speaking with patients, families, and others to maintain sound community relations. Positively affects the patient’s experience at ENT Institute.
·Ensures that professional services are captured and coded and ensures coding compliance with federal regulations and insurance requirements. Ensures that CPT and ICD codes are aligned so that there will be no question as to the relationship between diagnosis and treatment and the claim will be reimbursed.
Evaluates and interprets medical records and reports in order to accurately code diagnoses and procedures. Based on the provider's documentation identifies possible documentation changes which, if implemented, would more accurately account for services provided. Presents findings to provider and works to resolve issue.
Matches charge documents to appropriate billing sheets, operative reports, and medical records to ensure correct codes are applied and all billable procedures are captured.
Correctly enters coding information into an Athena, electronic medical record system.
Knowledge of medical coding guidelines and regulations including compliance and reimbursement * Working knowledge of managed care, commercial insurance, Medicare/Medicaid
Understanding and adherence to HIPAA and PHI guidelines
Responds to or clarifies internal requests for medical information
Ensure patients initial fee ticket at each visit to verify their demographics/insurance.
Investigate and appeal unpaid and partially paid claims, serve as resource to AR Specialists on coding denials
Maintains strict confidentiality of patients, employees, and hospital information
Keeps up to date on billing/coding rules, including the annual update of CPT-4 and ICD-10 codes. Maintains CEUS needed for certification
Perform all job functions in compliance with applicable federal, state, local and company policies and procedures.
Develops and monitors coding tasks
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