GENERAL SUMMARY OF DUTIES:
Reviews and codes surgical operative notes for one or multiple surgical practices. Resolves complex coding scenarios. Provides feedback and documentation advice to the physician and practice management. Works with AR to resolve coding related denials.
DUTIES INCLUDE BUT NOT LIMITED TO:
Reviews and codes complex operative procedures for surgical practices.
Coordinates and reconciles multiple surgical schedules to ensure complete charge capture.
Charge entry of multiple surgical cases into billing system in a timely manner.
Work in conjunction with A/R team on follow up and resolution of coding related denials and rejections
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-9/ICDD-10 materials, the Federal Register, and other pertinent materials.
Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.
Maintains strictest confidentiality.
Assists in the auditing of surgical practices.
Tracks denial patterns for surgical practices to address systemic issues
Available to assist and direct the practice or other appropriate staff in surgical documentation, billing, coding, and reimbursement issues.
Performs related work and projects as required.
Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”.
Meets designated productivity and accuracy rate of 95%.
KNOWLEDGE, SKILLS AND ABILITIES: This position requires the following minimum requirements:
- Knowledge of surgical coding & reimbursement practices/strategies.
- Knowledge of eCW billing system and/or other related billing system.
- Familiar with third party fee profiles and reimbursement requirements.
- Skill in exercising initiative, judgment, discretion, and decision-making to achieve organizational objectives.
- Aptitude for establishing and maintaining effective working relationships with physicians, clinic staff and other HCAPS Departments and personnel.
- Skill in problem-identification and problem-resolution.
- Must be computer literate, including Excel and Word skills.
- Experience with 3M encoding product or Encoder Pro preferred
- Must be detail-oriented and able to meet targeted deadlines.
- Strong knowledge and understanding of surgical practice coding and regulatory compliance.
- Knowledge of medical terminology and anatomy and physiology is preferred.
Must be one of the following:
Certified Coding Specialist (CCS)
Certified Coding Specialist – Physician (CCS-P)
Registered Health Information Technician – RHIT
Registered Health Information Administrator – RHIA
Certified Professional Coder - (CPC®)
Certified Professional Coder – Hospital (CPC-H®)
- Three year of experience in surgical coding and/or reimbursement activities is required.
- In addition, a clinical background and previous chart abstraction experience is preferred.