Day-to-Day Responsibilities
Review and code professional fee encounters using ICD-10-CM, CPT, and HCPCS guidelines.
Assign accurate E/M levels, diagnoses, and procedure codes to ensure compliant reimbursement.
Abstract key patient and encounter data for billing, regulatory, and reporting purposes.
Audit medical records to ensure documentation supports services billed and identify documentation gaps.
Communicate with physicians and providers to obtain coding and documentation clarifications.
Review and resolve coding-related claim edits, including medical necessity and NCCI/CCI edits.
Collaborate with billing and Accounts Receivable teams to resolve coding and reimbursement issues.
Maintain quality and productivity standards while meeting a 95% coding accuracy requirement.
Work within EMR, hospital information systems, and encoder software in a fully remote environment. Stay current on coding regulations, payer requirements, and continuing education requirements.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.