Job Summary:                                     

-        Accurately abstracts information from medical records and assigns ICD-10, CPT, Modifiers and HCPCS codes in compliance with established guidelines.

-       Reviews supporting clinical documentation for Physicians’ procedures to ensure accurate coding.

-       Compares medical charges posted against procedures coded and identifies any discrepancies.

-       Participates in special projects and completes other duties as assigned.

-       This position reports to the RCM Manager and has no direct reports.

 

Requirements and Experience:

To perform the job successfully, an individual should demonstrate the following competencies:

-       Certified Coder [CPC from AAPC or AHIMA] with 1-2 years’ experience in physician’s office with denials, accounts receivable and coding matters.

-       Experience with reimbursement in accordance with federal, state, and commercial health plans,

-       Medical claims, CMS-1500 form,

-       Medical Terminology,

-       Excellent computer skills,

-       High School Diploma or GED,

-       Experience with EHR preferred.

-       Helpful if you have e Clinical Works software system knowledge.

-       Medical chart review to identify new risk adjustment codes using CMS methodology.

-       Review potential risk adjustment codes for accuracy and provide evidence, recommendations, and documentation needed for codes.

-       Create provider[s] charts with code[s] recommendations and suggestions to improve quality.

-       Support and participate in process and quality improvement initiatives.

-       Solid knowledge with basic Microsoft Office Applications.

-       Comply with all company’s goals and objectives.

-       Annual TB Screening and Flu Vaccination required.

Benefits

We offer excellent comprehensive benefits package, including paid vacation and holidays; medical, dental, vision, disability & life insurance, and 401K with a company match once employee is vested.