Summary

Obtain appropriate reimbursement levels for services by reviewing diagnosis and procedure coding. Analyze denial reports and appeals whenever appropriate. Audits provider records and provides education.

Essential Duties & Responsibilities

1 Reviews documentation to ensure appropriate procedure and diagnosis codes are assigned. Knowledge of medical terminology and medical abbreviations
2 Maintains a working knowledge of CPT-4 and ICD-9 cm coding principles, governmental regulations and requirements pertaining to billing and documentation
3 Conducts a review of records to ensure compliance with coding and documentation guidelines
4 Provides written reports to manager with audit results
Conducts educational sessions with providers regarding results of periodic reviews
Researches and provides accurate and timely answers to provider coding and billing questions

Required Qualifications :

Certified Professional Coder, by AAPC or AHIMA

Preferred Qualifications:

Certified Professional Coder either AAPC or AHIMA, 3-5 years of coding experience