Certified Medical Coder
- Review E/M, diagnostic and procedural documentation and assign correct CPT and diagnosis codes.
- Work with RCM team to identify patterns, trends and variations in coding and documentation practices.
- Prepare documentation summary/findings to support development of corrective action plans.
- Assist management team in the development of effective education programs for staff.
- Provide on-going guidance to RCM team on the correct use of modifiers.
- Assist RCM team with documentation required to appeal claims and overturn denials.
- Assess claims to ensure adherence with payer guidelines.
- Research and work collaboratively with clinic staff to capture all billing activities (e-bill management).
- This may require access to additional information systems (EMR or Data Warehouse).
- Respond to RCM team and vendors promptly to address information needed for claim resubmission and denial resolution.
- Assist in the development of protocols and workflows to ensure correct billing and maximum reimbursement.
- Maintain productivity and accuracy standards as determined by each division.
- Deliver exemplary customer service in order to provide a positive experience across the organization.
- Perform other duties assigned by management.
- Current CPC, CCS, RHIA or RHIT certification required, Associates degree or equivalent experience preferred.
- 1-3 years of progressive coding experience preferred.
- Working knowledge of anatomy, physiology and medical terminology required, Experience working in EMR system preferred.
- Ability to multi-task required, strong organizational skills.
- Strong customer service and communication skills with ability to utilize computer programs.
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