Hill Physicians Medical Group
San Ramon, CA, USA
Certified Medical Coder Job Description To provide timely clinical and coding review of claims and claims appeals related to CPT, HCPCS and/or ICD-10 coding, to ensure accuracy of modifiers, place of service and/or date of service and to make processing recommendations per established clinical and/or coding criteria/conventions. To provide support and consultation to various Internal Departments as a Clinical Code Resource and in processing of memorandums of understanding (MOU). Job Responsibilities Perform clinical claims review and evaluate billed services for coding accuracy and appropriateness while meeting claim turnaround times(TAT) and maintaining unit production goals, utilizing various resources such as Hill Physicians Guidelines, Health plan policies/guidelines, Milliman Care Guidelines, ClaimCheck, CPT, Encoder, etc. and obtaining additional medical information as necessary. Manage/prioritize claims related issues from various sources such as electronic...
