Assign ICD, CPT and HCPCS codes to all relevant physician claims. Ensure that E&M levels are accurate and documentation supports appropriate level assigned and medical necessity of service. Ensure all demographic and insurance data is accurate based upon information contained within the documentation.
• Communicate with providers and practices to ensure all encounter forms are current.
• Disseminate information regarding new codes and/or coding policies either by payer or through regulations.
• Create and maintain department processes and controls according to Professional Coding Standards, CMS Standards, HIPAA, OIG, and the State of Massachusetts as well as national payor coding guidelines as they pertain to professional coding and reimbursement.
• Educate providers and clinical staff through review and education of documentation.
• Champion coding compliance, through Revenue Cycle team utilization of recognized professional references, and adherence to established coding convention and regulation.
• Participate in departmental and physician network performance improvement initiatives.
• Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.
• Other duties as assigned.
• Associate's degree in Health Information Technology or related business degree or equivalent amount of education and experience.
• Current certification as a CPC or CCS-P.
• Specialty coding and auditing.
• Computer literacy of medical information system, records management software, encoders.
• Demonstrated coding (ICD-9-CM and CPT) expertise.
• Understanding of third party reimbursement rules and regulations.
• Experience with encoder software.
• Ability to work independently with minimal supervision.
• Professional interpersonal and organizational skills.
• Attentive to detail and organization.
Job Status: Full Time
Job Reference #: 4739