CODER ANALYST SPEC-CLNIC

Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Assists the Billing Department in timely billing and rebilling of patient information.

Requirements

• Reviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities.
• Verifies data in the medical record and accurately abstracts pertinent information for charge entry.
• Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal procedure(s) and related diagnosis.
• Edits unbilled claim transmission reports daily and makes necessary corrections to ensure accuracy and timely billing.
• Participates in quality coding and audit reviews for each provider.
• Assists provider with coding questions for all services rendered.
• Assists other coders with coding questions to determine the most appropriate codes used for billing compliance and refers coding questions to the Operations Manager when additional research is needed.
• Contacts physicians for clarification and medical necessity.
• Reviews all encounters for accurate documentation and coding of services rendered.
• Communicates pending items and questions with office manager, CDI supervisor, and manager.
• Demonstrates ability to meet or exceed practice quality and quantity standards.
• Liaison between practice specialty and insurance company for benefit determination and claim rejections.
• Follows policies, procedures, and safety standards.
• Completes required education assignments annually.
• Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.