Performs CPT and ICD10 coding through abstraction of the medical record with a focus on Evaluation and Management services
Utilizes technical coding expertise to review the medical record thoroughly and assign appropriate CPT, ICD10 codes and modifiers
Provides documentation feedback to physicians and trains physicians and other staff regarding documentation, billing and coding
Reviews and communicates new or revised billing and coding guidelines and attends meetings and educational roundtables
Resolves pre-accounts receivable edits and Optum coding edits; makes appropriate changes to incorrectly billed services and adds missing unbilled services
Identifies and reports repetitive documentation problems and system issues
Collaborates with Patient Accounting, PB Billing, Revenue Cycle and Account Inquiry Unit staff to provide coding reimbursement assistance and resolve claim issues
Meets established minimum coding productivity and quality standards and may perform other duties as assigned
Requirements
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS)
Zero (0) to two (2) years experience in a relevant role
94% accuracy on organization's coding test
Ability to follow Official Guidelines to assign appropriate CPT and ICD10 codes and modifiers with a minimum of 95% accuracy
Understanding and knowledge to resolve Optum coding edits
Must reside in Illinois, Indiana, Iowa, or Wisconsin
Preferred: Bachelor's degree or Associate's degree in a Health Information Management program accredited by CAHIIM
Preferred: Previous experience with physician coding