Job Summary
Apply diagnostic & procedural codes to individual patient individual health data for claims processing and ensure the claims are paid by payers.
Review denials for coding lapses and suggest corrective and preventive actions.
Review E/M charts and minor procedures, Lab and imaging performed during the visit.
Key Responsibilities & Duties
Thorough understanding of the contents of medical record in order to identify information to support coding.Sound knowledge of anatomy & physiology of human body and diseases in order to understand etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and procedures to be coded.Should have an understanding of claims form and reimbursement process.Abstracts pertinent information from patient medical records.
Assigns ICD-10-CM, CPT/HCPCS codes, and modifiers.Utilizing CCI edits, LCD policies, CPT and Clinical guidelines while assigning codes.Reviews denials for coding lapses and suggests coding changes for corrective and preventive (root cause) action by DHT (denial handling team) team.Actively reviews denials and research to create claims scrubber edit which will prevent specific coding denials permanently.Qualification/Experience
Must be a graduate, preferably in Life Science, with basic training in medical transcription or medical coding, or coding certificate program with AAPC/AHIMA certification status (CPC/CCS) preferred.
Must be ICD-10 certified.Minimum of 2 years of experience in E&M and Denial coding.Strong knowledge of medical terminology, anatomy, and physiology.Excellent attention to detail and analytical skills.Effective communication skills, both written and verbal.Ability to work independently and as part of a team.Familiarity with electronic health record (EHR) systems.Convinced?
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