Reviews codes for accuracy in accordance with coding rules and policies. Responsible for system edit reviews and follows up on insurance coding denials for resolution.
Uses coding system knowledge and workflow logic to review codes created by electronic charge capture and/or assigns codes from medical record documentation. Completes system edit reviews to make corrections before transmittal.
Troubleshoots issues that prevent claims from being released, identifies the cause of edits, and independently resolves problems by reviewing patient encounters. Provides feedback for correction and follow-up.
May abstract data and review codes for accuracy to support accurate reimbursement based on guidelines and/or provider documentation.
Responds to coding information requests and consults with internal customers and external vendors when documentation is inconsistent or incomplete.
High school diploma or equivalent with 1 year of medical coder experience required.
Associate's 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
Intermediate Level
Remote work allowed
Yes
Posted
2 weeks ago