Coder II- Days

Found in: Jooble US O C2 - 2 weeks ago

Tupelo MS, United States North Mississippi Health Services Full time

At North Mississippi Health Services, our mission is to continuously improve the health of the people of our region. Our vision is to provide the best patient and family-centered care and health services in America. At North Mississippi Health Services, we believe in connecting your passion with a purpose. Coding: Assign diagnostic and procedural codes using ICD-10-CM and CPT coding systems for inpatient, outpatient, and ambulatory surgery records in order to ensure accurate billing and statistical information by reviewing provider documentation. Apply coding knowledge of ICD-10-CM and CPT to denial review to ensure accurate coding, compliance and reimbursement. Research and apply coding/billing guidelines for various carriers. Knowledge of Hierarchical Condition Category coding to ensure accurate diagnosis coding and future reimbursement.
Reimbursement: Apply local Medical Review Policies regarding medical necessity to all insurance carriers procedures to ensure appropriate reimbursement for the provided service. Follow up with insurance carriers on outstanding appeals and/or incorrect allowable/reimbursement. Identify reimbursement opportunities through documentation review and denials for NMMCI and MSO=s.
Research causes for insurance denials by reviewing provider documentation, medical policy, and coding guidelines. Determine if the documentation is compliant with guidelines and supports all services billed. Corrections are made to the patient=s account and with insurance carrier as needed.
Compliance: To abide by NMHS Coding Compliance Policy, ICD-10-CM and CPT Coding Guidelines and Standards of Ethical Coding. Determine if provider=s documentation meets coding guidelines and involve the Coding Specialist to provide education as needed. .
Customer Service: Effectively interacts and assist NMMCI and MSO clinic managers, charge entry personnel, and physicians with determining appropriate CPT codes for their charges, coding guidelines, medical policies and education to gain trust, commitments, and a strong work relationship.
One year previous outpatient coding experience with and CPT coding schemes including evaluation and management codes and experience with insurance carriers, preferred. Thorough knowledge of medical terminology, previously completed course in basic anatomy and the ability to read and interpret medical record documentation.

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