CHARGE ENTRY/REVIEW – Perform charge reviews in appropriate database (minimum of 35 per day). Review of physician coded encounters for accuracy of ICD-10 and CPT codes and confirms adequate teaching provider documentation. AT the direction of the Coding Supervisor, perform clinic and hospital chart reviews to provide results to the department compliance educator. Provide education on coding and documentation improvement. Provide education to physician, residents, ARNP’s, PA’s and staff in regards to documentation, reimbursement, and compliance. Provides feedback to providers regarding billing and coding questions and works with provider to resolve these questions to ensure accurate coding.

EDUCATION AND CODING COMPLIANCE – Researches coding issues through all available resources, including but not limited to professional associations, federal and private payer guidelines, and coding networks. Keeps abreast of annual coding updates. provide education to providers in regards to documentation, reimbursement, and compliance. Provides feedback to provider regarding billing and coding questions and works with the Coding Supervisor to resolve these questions to ensure accurate coding.  Will conduct one on one meetings to provide the feedback referenced above.

REIMBURSEMENT REVIEW –  Reviews claim work queues and denials for coding issues and provider education. Review charge entry edits and payer denials to provide education to faculty and staff.

Other duties as assigned by the supervisor.

Proficiency in data entry required. Knowledge of anatomy and medical terminology required. Knowledge of Documentation and Coding Guidelines for outpatient clinic and physician hospital services. Excellent verbal and written communication skills required to effectively work as a liaison with all individuals contacted during the course of work. Analytical skills developed through formal education or on the job training with a medical practice or other health care organization. Demonstrated competence with personal computer or other computer systems. Must possess skills to research coding issues through all available sources, including but not limited to professional associations, federal and private payor guidelines, and coding networks. Experience with a billing and coding system such as Epic.