What are the responsibilities and job description for the Medical Coder position at Hornet Staffing, Inc, a GEE Group company?
Notes: Please share your most updated resume if you are interested for the role
Duties
- Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
- 75% Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates. •15% Manages records retrieval, release, HIPAA compliance, and all aspects of document management. •10% Serves as expert resource on methodology and procedures for medical records and coding issues.
Required Training:
- Registered Records Administrator or Technician, OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR
- Certified Codi Skills and Abilities: •Develops methodologies •Follows processes •Responds to Inquiries •Writes for Impact