This position is responsible for coding records by established guidelines to ensure appropriate reimbursement. Code records by the appropriate coding scheme and verifies the accuracy of the data contained within the medical record. All coding utilized is to be in compliance with Federal, State, and insurance payer guidelines, and The Surgical Clinic compliance and operational standards.
Essential Duties and Responsibilities
• Codes records by the appropriate coding scheme (CPT, HCPCs, and/or ICD-10) utilizing approved coding guidelines
• Retrieves and sequences complications and co-morbidity from records to ensure appropriate reimbursement
• Communicates with physicians on clarification of principal and secondary diagnoses
• Accurately, enters pertinent billing information in to the electronic medical record
• Maintains a listing of records that require diagnoses and makes any necessary changes to alleviate this. Contacts the physician offices to obtain diagnoses or clarification on diagnoses in a timely and professional manner.
• Communicates with the CBO Supervisor and/or Director of Revenue Cycle on coding and reimbursement issues that need to be clarified; additionally, informs Director and Practice Management of potential risk management issues
• Enters and accesses data appropriately in the applicable electronic medical record
• Meets productivity standards and deadlines
• Complies with requests from various payers
• Assists physicians and other healthcare practitioners with chart completion by pulling records upon request in a timely and professional manner
• Works closely with Central Business Office staff to address coding issues that might impact account receivables and appeals
• Work with ancillary departments to assist in correcting inappropriate modifier usage
• Assists with other billing duties as assigned