Description

You will review and code medical records to drive clinical documentation improvement, reimbursement accuracy, and compliance enforcement.

Responsibilities

• Review professional and hospital charges to ensure documentation supports billed codes using ICD-10-CM, CPT/HCPCS, and governmental guidelines.
• Develop and execute educational resources and training tools for providers based on documentation review trends and regulatory changes.
• Advise physicians and staff on questions regarding documentation, coding, and billing guidelines.
• Provide recommendations to leadership to modify processes that do not meet regulatory or legal compliance standards.
• Act as a liaison between departments to resolve coding policy and payment issues.

Required Skills

• AHIMA or AAPC coding credentials.
• 1 to 2 years of experience reviewing medical documentation.
• Proficiency with various Electronic Health Records (EHR).
• Knowledge of medical billing, coding, and claim submission operations.
• Understanding of ICD-10-CM and CPT/HCPCS coding systems.
• Knowledge of legal and policy constraints pertaining to patient billing.
• Ability to prioritize medical record reviews and provider education projects.
• High school diploma, GED, or equivalent training/experience.

Key Skills

Education

ANY GRADUATE