Responsible for daily coding, auditing, and diagnosis-related group (DRG) validation of assigned encounters to ensure accuracy and compliance with outpatient standards.
Conduct reviews and provide recommended corrections of billed services for medical records, ensuring accuracy and compliance with current coding guidelines and regulations.
Perform DRG validation to ensure appropriate assignment based on clinical documentation and coding.
Review and audit billed services, providing recommended corrections related to clinical documentation to maintain coding integrity.
Assist in reviewing and responding to payer and governmental audits of billed services.
Stay current with and apply new coding guidelines and codes, maintaining expertise in CPT, HCPCS, and ICD-10 coding systems.
Meet established daily accuracy and production standards as outlined by department policy.
Collaborate with healthcare team members to ensure continuity of services and clarity in clinical documentation.
Required
- High school diploma or GED
- One or more of the following credentials: Certified Coding Specialist (CCS) through AHIMA, or Certified Professional Coder (CPC) and Certified Outpatient Coder (COC) through AAPC
- At least 1 year of inpatient medical coding and DRG validation work experience
- Strong analytical, interpersonal, and communication skills
- Ability to produce detailed, comprehensive documentation and reports
- Passing scores on job-related pre-employment assessments
Preferred
- Experience in coding or medical billing quality control
Other
- Comfortable with remote work arrangements and virtual collaboration tools
- Ability to meet physical demands including extended periods of sitting, computer use, and telephone communication
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago