Responsible for abstracting, coding, and interpreting outpatient clinic and provider services for professional and/or facility billing. Uses coding knowledge to abstract and record data from medical records, support documentation and coding needs, and code complex or specialty services. May serve as a resource for other coders and is not responsible for providing care to patients.
Responsibilities
- Perform final reconciliation on clinic or provider visits and resolve missing, incomplete, or inconsistent documentation by contacting appropriate personnel.
- Review, abstract, and code multiple or subspecialty services and complex or unusual cases, assigning appropriate coding classifications.
- Serve as a resource to coding staff, business office, providers, hospital staff, clinic managers, and other clinical personnel on billing-related issues.
- Research and resolve high-volume accounts, complex or escalated suspended claims, and compliance issues using appropriate databases.
- Research, interpret, and apply regulatory guidelines to coding and reimbursement decisions.
- Assist in the auditing process.
- Train level I and II coders and may serve as a project lead.
- Assist with backlog to maintain department quality and productivity standards.
- Support other department coding needs as requested.
- Participate on committees and work groups as needed.
- Present information to providers and assist in training efforts regarding coding and billing.
Requirements & Qualifications
Required Qualifications
- AHIMA- or AAPC-recognized certification such as CCA, CPC, COC, CPC-H, CPC-P, CCS, CCS-P, RHIA, RHIT, or other specialty certification indicated by the department.
- Three years of coding, clinical, or billing experience.
Preferred Qualifications
- Experience organizing and conducting coding or billing education.
Knowledge, Skills, and Abilities
- Demonstrated leadership, human relations, and effective communication skills.
- Knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations.
- Knowledge of health insurance processing.
- Proficiency with computer software such as Microsoft Word and Excel.
- Ability to maintain certifications through continuing education credits.
- Ability to effectively train others.
- Knowledge of CMS, AMA, and AHA coding and billing guidelines.
Physical Requirements
- Listening
- Sitting
- Speaking
Location
Utah, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 month ago
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