Medical Billing and Coding

• Analyze medical records, interprets documentation, and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD 10 CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), and modifiers utilizing designated software, coding manuals and other reference material as required
• Enter charges for procedures that are not soft coded as instructed for certain patient types
• Consistently meet coding quality and productivity standards established by the coding department
• Work closely with Patient Financial Service (PFS) to review documentation and serve as department expert on coding questions.
• Assist with coding inquiries from billing and administrative staff, ensuring that accurate codes are applied for appropriate reimbursement
• Gather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract
• Review and resolve clearinghouse rejection errors, denials, and charge review/claim edits daily. Also reviews accounts returned from various departments and processes corrections for clean claim submission
• Collaborate with the Compliance/Quality Team when alerted to coding quality issues found via internal or external reviews; implement with accuracy coding quality recommendations
• Work with HIM operations as needed to clarify queries and documentation needs for the completion of the medical record.
• Query providers for clarification on incomplete or ambiguous documentation and follow up to ensure timely resolution
• Review and code Orthopedic, OB/GYN, and other surgical specialties procedures with minimal supervision, ensuring correct coding and sequencing of diagnoses and procedures
• Provide continuous education and feedback to surgeons and clinical staff regarding ICD-10 coding and documentation best practices for surgical procedures.

Provider Coding Specialist – Orthopedic

Certified Coder, Appeals

Surgical Coding Specialist II

Provider Coding Specialist

Provider Coding Specialist – OB/GYN