Assigns and reviews the accuracy of diagnostic codes (ICD-10-CM) and CPT codes for providers' evaluation and management services, procedures, and diagnostic testing across all settings for billing, research, and reporting purposes.
- Reviews medical record documentation to assign ICD-10-CM, CPT-4, HCPCS, and modifiers accurately and in a timely manner.
- Reviews and resolves charge sessions, claim edits, and follow-up work queues.
- Manages assigned charge review and coding-related work queues to ensure accurate charge capture.
- Assists physicians and providers with coding and documentation questions.
- Provides feedback and identifies education opportunities based on coding/documentation trends.
- Ensures coded services comply with governmental regulations, NCCI, and payer-specific guidelines.
- Uses coding resources and systems such as Epic, imaging systems, lab systems, emergency systems, and reference materials.
- Trains and mentors Coding Quality Specialist Level 1 staff as directed.
- Assists coders with medical terminology, disease processes, and surgical techniques.
- Performs peer review and queries providers when documentation clarification is needed.
Requirements & Qualifications
High school diploma or GED.
Three years of coding or clinical experience.
Specialty experience strongly preferred in one or more of the following areas:
- Adult and pediatric outpatient pulmonology, including bronchoscopies and pulmonary function tests
- Hematology and oncology
- Endocrinology
- Nephrology, including dialysis billing
- Infectious disease
- Allergy
- Genetics
- Pediatric development and neurology, including nerve blocking injections and EEGs
Must hold one of the following credentials:
- CPC through AAPC
- CCS-P through AHIMA
Benefits & Perks
Comprehensive medical, dental, and vision insurance.
- Paid time off
- Short-term and long-term disability
- Retirement savings
- Health savings plans and flexible spending accounts
- Certification and education support
- Generous paid time off
Location
Virginia, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 months ago
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