Review charge documentation from the clinic and/or hospital
Accurately assign diagnosis and enter procedure codes into billing system using ICD-10-CM, CPT-4, HCPCS and other appropriate coding systems
Perform regular auditing of coding throughout the practice, communicate findings to management, and provide recommendations based on the audit findings
Communicate effectively with physicians and staff regarding correct coding and documentation processes
Review daily reports for coding exceptions and follow up as required
Work with A/R team on follow up and resolution of coding related denials and rejections
Monitor professional publications, payer publications, and websites to remain up to date on coding changes relevant to the practice and communicate as necessary
Confirm patient demographic, insurance and referring physician information is accurately entered into medical management system
Confirm insurance verification and authorizations, as required
Communicate with Accounts Receivable Specialist regarding insurance authorizations
Review daily physician schedules and evaluate office consults and office visits for appropriate complexity using CPT coding guidelines
Enter all CPT and ICD-10 into the practice management system for charge processing
Respond to audit findings and make applicable coding additions or corrections
Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates
Update computer system and note section in patients account with any changes made to patient information or as otherwise dictated by company policy and procedure
Confirm all appropriate charges are received and completed each week, and meets required regulations
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations
Other projects as assigned
REQUIREMENTS
Certified Coder, e.g., CPC, CCS-P, or ROCC
Knowledge of coding including CPT-4, HCPCS II, and ICD-10-CM
Minimum of three years of coding experience in a healthcare setting
Ability to understand and interpret clinical documentation and follow the department billing processes at a detailed level
Excellent verbal and written communication skills
Must be detail-oriented and able to meet targeted deadlines
