Maintains knowledge of, and complies with, all relevant laws, regulations and policies, procedures and standards.
Actively participates in creating and implementing improvements to achieve clinical, satisfaction and/or efficiency outcomes.
Audits diagnostic (ICD-9-CM) and/or procedural codes (CPT and HCPCS) on all medical record types at an advanced level to ensure proper reimbursement and accurate database information.
Assigns modifiers according to established procedures and guidelines.
Assigns Evaluation and management (E/M) and CPT procedure codes for clinician services to assure appropriate billing and reimbursement. Codes E/M services according to Medicare documentation guidelines.
Codes accounts while meeting or exceeding accuracy standards and a minimum of 75 charts per day. Achieves and maintains a measurable coding error rate of 5% or less.
Assists in daily and weekly monitoring of unbilled/un-abstracted lists to facilitate all reimbursement, keeping Accounts Receivable within established goals. Responsible for working coding denials according to set goals and objectives.
Reviews charts and provides education to clinicians on coding and billing in individual and group sessions. Queries clinicians on documentation according to established procedures and guidelines.
Interacts with clinician and other clinic/corporate departments to assure compliance and appropriate billing practices. Resolves any questions concerning diagnosis, procedures, clinical content of the record or code selection through research and communication as indicated by feedback and observation by manager.
May provide education and feedback to staff as assigned.