Job Description
Under general supervision, responsible for conducting the quality review of inpatient and outpatient coding, assures coding compliance with federal regulations, and maintains up-to-date coding guidelines and coding policy changes.
Responsibilities
- Reviews, interprets, and assigns diagnostic and procedural codes based upon medical record documentation according to correct coding principles.
- Provides skilled and specialized technical work in documentation and coding for medical billing, abstracts complex patient-related data from medical records and coding of diagnoses and procedures using ICD-10 and CPT codes.
- Works coding related charge review and claim edits daily to ensure timely and accurate billing.
- Researches and resolves coding related issues, and assists in meeting productivity and quality standards.
- Verifies charge entry and physician notes for completeness to include abstracting and entering relevant medical information from the medical records; checks for required signatures; assures proper documentation guidelines are followed.
- Review medical records and charge fee information from patient care area.
- Contacts other facilities to obtain medical records and information needed to bill for services rendered.
- Reviews EPIC queues and correct coding edits.
- Codes diagnosis and procedures using classification coding systems.
- Reviews charge documents for completeness.
- Performs all other duties as assigned.
Qualifications
- Proficiency in ICD-10 and CPT coding.
- Fundamental understanding of medical terminology, anatomy and physiology.
- Meticulous attention to detail and accuracy.
- A solid customer service acumen and interpersonal skills to effectively work with both internal and external customers and responds to requests in a timely and respectful manner.
- Strong verbal, written and interpersonal communication skills.
Education
- High school diploma or GED is required
Required Skills
- Three (3) years experience in medical record abstraction and coding is required.