This position is responsible for translating and analyzing the appropriateness of medical codes and applying them to medical claims.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Makes determination of appropriate diagnosis codes to claims, by using ICD-9.
- Assigns appropriate procedure codes using CPT and HCPCS.
- Reconciles proper diagnosis codes with appropriate CPT codes, for claims purposes.
- Verifies the provider, origin of service, and language of claim.
- Queries provider(s) for additional information as needed to complete accurate coding tasks.
- Codes all in-coming claims based on U.S. standards.
- Complete coding projects that are given by management and follow-up.
- Enters data into the systems as needed.
EDUCATION AND/OR EXPERIENCE:
Must be certified with CPC, CPC-P, CCS, or CCS-P, or RHIT, RHIA; with six months to a year of related experience and/or training in medical and dental coding; or equivalent combination of education and experience.
OTHER SKILLS AND ABILITIES
Expert level in one of the following languages is preferred, but not required:
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