Reports to the Coding Manager and reviews outpatient clinical documentation to extract data and assign appropriate ICD-10-CM and CPT codes in accordance with official coding guidelines. Reviews medical records to ensure documentation supports code assignment, uses 3M 360 Finder for code assignment and claim edit resolution, confers with physicians as needed, and monitors outpatient uncoded reports to support timely coding and billing.
The role also enters coded abstracted information into 3M 360 Finder, assigns APCs, reviews coding edits, applies NCCI and medical necessity requirements, resolves claim edit database accounts, assigns injection and infusion codes for observation patients, and maintains quality and productivity standards.
Additional duties include assigning E/M, ICD-10-CM, CPT, or chargemaster codes to clinic visits, validating physician-entered diagnosis and procedure codes, identifying and resolving NCCI edits before final billing, reporting documentation insufficiencies, monitoring rejected accounts, researching coding conflicts, updating patient financial accounts, rebilling as needed, and performing related clerical duties.
High school diploma or equivalent.
Successful completion of a formal coding educational program.
Ability to read and understand outpatient clinic medical record documentation for outpatient clinic, ancillary, and endoscopy coding.
Coding certification from AHIMA or AAPC required.
One to two years of experience in outpatient coding or billing.
Ability to meet and maintain quality and productivity standards.
Ability to work independently and refer complex issues to a supervisor when needed.
Location
Rhode Island, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago