Assign ICD, CPT and HCPCS codes to all relevant physician claims. Ensure that E&M levels are accurate and documentation supports appropriate level assigned and medical necessity of service. Ensure all demographic and insurance data is accurate based upon information contained within the documentation.
Reach out to providers and practices to ensure all encounter forms are current, disseminate information regarding new codes and/or coding policies either by payer or through regulations. Create and maintain department processes and controls according to Professional Coding Standards , CMS Standards, HIPAA, OIG, and the State of Massachusetts as well as national payor coding guidelines as they pertain to professional coding and reimbursement. · Educates providers and clinical staff through review and education of documentation.
Champions coding compliance, through Revenue Cycle team utilization of recognized professional references, and adherence to established coding convention and regulation.
Participates in departmental and physician network performance improvement initiatives
Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.
- 2 years Associate degree in Health Information Technology or related business degree
- Current certification as a CPC or CCS-P.
- Specialty coding and auditing
- Computer literacy of medical information system, records management software, encoders, Email
- Demonstrated coding (ICD-9-CM and CPT) expertise.
- Understanding of third party reimbursement rules and regulations.
- Experience with encoder software
- Ability to work independently with minimal supervision.
- Professional interpersonal and organizational skills.
- Attentive to detail and organization.
Steward Health Care - 14 months ago
St. Elizabeths Medical Center
Steward Health Care
- 16 days ago
Certified Professional Coder
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