A Coder I performs coding audits for quality checks and provider education.
Performs coding and auditing of medical record documentation to ensure accurate coding. Maintains working knowledge of coding and compliance, supports coding training across TPMG locations, and participates in coding-related denial meetings.
Reviews and submits documentation for RAC, CERT, TPE, and insurance carrier requests with timely follow-up. Works with providers and clinical staff to improve documentation and coordinates with the Central Billing Office to support appropriate reimbursement.
Reviews denied claims and retractions, makes corrections when appropriate, and assists with denial and retraction appeals. Collaborates closely with Coding and Compliance Auditors and the SWAT Team.
Other duties as assigned.
Required Qualifications
- High school diploma or GED
- Up to 2 years of related experience or training
- Up to 2 years of experience in the medical billing field with coding experience
- Active CPC, CCS, COC, CCS-P, or CCA certification required
Knowledge and Skills
- Knowledge of CPT, ICD-9, ICD-10, and HCPCS coding
- Knowledge of medical terminology
- Experience with NextGen and Encoder Pro preferred
- Ability to read and follow oral and written instructions and written protocols
- Ability to examine documents for accuracy and completeness
- Strong customer service skills
- Ability to multitask
- Strong verbal and written communication skills
- Organized presentation of information
- Accuracy and attention to detail
Location
Virginia, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago