United States onlyCoder Professional-3 is responsible for professional coding, including the assignment of ICD-CM, CPT, and HCPCS codes, modifiers, and evaluation and management (E/M codes) provider audits. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations.
Requirements
- Analyze and confirm assigned encounters for provider's selection of EM code level utilizing EM code level selection auditing tool.
- Assists physicians with record documentation needs by requesting clarification for additional information.
- Assists in educating physicians and ancillary staff members about documentation needed for coding process.
- Contacts physician offices and/or SBL departments as needed for diagnostic information to code the encounter.
- Assists with training new coding staff as requested.
- Codes all types of encounters as assigned and assists co-workers as needed.
- Codes and resolves clinic, hospitalist, ED, and applicable ancillary services professional encounters based on established production standards.
- Ensures data quality and optimum reimbursement allowable under the federal and state payment systems.
- Meets quality standards of having 95% of diagnoses and procedures appropriately and/or correctly coded.
- Performs follow-up on encounters that need to be coded and resolved.
- Reviews and corrects all encounters that are rejected or denied.
- Reviews record thoroughly to ascertain all diagnoses/procedures. Codes all diagnoses/procedures in accordance to ICD-CM and CPT coding principles, official guidelines and regulations.
