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Appropriately codes diagnosis and procedures to patient charge encounters using correct coding conventions. Within clinical department may also be responsible for collections of payments.
PATIENT AGE GROUP SERVED
Indirect patient care
DUTIES AND RESPONSIBILITIES
Using ICD-9 standards, codes and abstracts medical records for reimbursement purposes from patient charts, physician documentation, medical diagnostic and /or interventional reports.
Reviews individual medical records to verify and substantiate diagnosis and procedures.
Matches charge documents to appropriate billing sheets, operative reports, and medical records to ensure correct codes are applied and all billable procedures are captured.
Ensures patients are charged for all procedures via encounter form.
Code clinical visits, surgery charges and laboratory procedures.
Communicates with physicians to obtain or clarify diagnosis.
Batch daily charges
Responds to or clarifies internal requests for medical information.
Verifies accuracy of claim forms for correct diagnosis and procedure order, service dates, place of service, etc.
Submit claims to appropriate primary and secondary payers.
Expedite and maximize payment of claims by contacting 3rd party payers and patients.
Investigate and appeal unpaid and partially paid claims by 3rd party payers.
Accountable for ongoing professional growth and development
Maintains strict confidentiality of patients, employees and hospital information at all times.
Performs other duties as assigned
High School Diploma or G.E.D.
2 years minimum experience required coding predominantly diagnosis procedures in a clinical environment.
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
Certified Procedural Coder (CPC)
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
Strong customer service, phone and scheduling skills
Knowledge of insurance requirements for physician visits and procedures
Knowledge of requirements for non-invasive lab procedures
Extended periods of walking and standing may be required.
Patient care unit conditions
Universal precautions required
Significant potential for exposure to Latex