Reviews codes for accuracy in accordance with coding rules and policies, with responsibility for system edit reviews and follow-up on insurance coding denials.
- Uses coding system knowledge and system logic to review codes created by electronic charge capture and/or assign codes from medical record documentation.
- Completes system edit reviews and makes corrections before transmittal.
- Troubleshoots issues preventing claims from being released and independently resolves edits by reviewing the patient encounter.
- May abstract data and review codes for accuracy to support proper reimbursement.
- Responds to coding information requests and consults with internal and external stakeholders to clarify incomplete or inconsistent documentation.
Requirements & Qualifications
- High school diploma or equivalent and 1 year of medical coding experience required
- Associate degree preferred
- Knowledge of ICD-10-CM, CPT, and HCPCS required
- Working knowledge of medical terminology and anatomy required
- AHIMA credentials such as RHIA, RHIT, or CCS preferred
- AAPC CPC or PMI CMC preferred
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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