What are the responsibilities and job description for the Medical Billing & Coding Specialist position at Southwest Network?
Essential Functions
- Audits charts and revies clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere
- Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits
- Complies with all medical coding guidelines and monitors evolving regulatory and industry changes
- Provides targeted education, direct coaching, and facilitates training programs tailored to each medica specialty upon translating audit findings
- Follows up and clarifies any information that i s not clear with the rendering provider
- Collaborates with IT and EHR teams to improve charge automation and optimize workflows
- Conducts ad-hoc audits to ensure fidelity to coding guidelines
- Relevant expert for Southwest Network on accurate and efficient coding practices
- Analyze medical records and identify documentation deficiencies
- Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program
- Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical and professional guidelines adopted by Southwest Network
- Other duties as assigned