Evaluate medical records and charge tickets to ensure coding completeness, accuracy, and compliance with ICD-10-CM and CPT guidelines.
Responsibilities include:
- Review medical record documentation and charge-ticket coding to support accurate reimbursement and outpatient visits.
- Identify and resolve documentation and charge discrepancies.
- Assign and sequence ICD-9-CM/ICD-10-CM and CPT codes based on clinical documentation.
- Perform edit checks and correct errors before transmittal.
- Research and recommend corrective actions to prevent future coding errors.
- Provide technical guidance to physicians and staff on coding, documentation, and reimbursement requirements.
- Collaborate with RI Specialists and the Denials team on Medicare reimbursement claim reviews.
- Help educate staff on proper code selection, documentation, and procedures.
- Update procedure manuals and stay current on coding regulations and documentation standards.
Requirements & Qualifications
Qualifications
- Knowledge of ICD-10-CM and CPT coding guidelines, medical terminology, and Medicare reimbursement guidelines.
- Experience with modifiers and coding rules, including AMA-related standards.
- Strong written and verbal communication skills.
- Ability to understand and apply payer requirements.
- Strong prioritization and problem-solving skills.
Education and Experience
- High school diploma or GED required.
- 2+ years of medical coding experience, or an associate degree in medical coding and billing, medical administration, or a related field.
Credentials
- CPC, RHIT, ART, or CCS coding credential required.
Systems
- Proficiency in Microsoft Excel, Word, PowerPoint, and Outlook.
- Experience with EHR software systems.
Location
Ohio, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago
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