Clinical Coder III
3 weeks ago
Clinical Coder III is a highly specialized role that requires expertise in diagnosis and procedural coding for operative procedures and inpatient consulting services performed by the faculty of the Department of Neurological Surgery. The incumbent will review operative reports and progress notes to determine documentation of billable services and apply the appropriate ICD-10 and CPT codes. This position also involves providing guidance and education to attending surgeons, fellows, and residents on coding issues and researching coding questions through various resources.
Key Responsibilities
- Performs highly specialized diagnosis and procedural coding for all operative procedures and inpatient consulting services performed by the faculty of the Department of Neurological Surgery.
- Reviews operative reports and progress notes to determine documentation of billable services and applies the appropriate ICD-10 and CPT codes.
- Provides guidance and education to attending surgeons, fellows, and residents on coding issues.
- Researches coding questions through various resources, including professional associations, federal and private payer guidelines, and coding networks.
- Meets with Department Chair or Administrator on a regular basis to review individual or product line coding issues.
- Verifies patient demographic and health insurance data for accuracy and resolves any discrepancies.
- Ensures that there are no unsigned or missing operative records and enters charges for both surgical cases and non-surgical inpatient events.
- Responsible for chart reviews for the purpose of regulatory and coding compliance and to ensure all services appropriate for coding and charging have been captured.
- Ensures proper documentation of teaching provider involvement and monitors and corrects all TES edits in the Epic system.
- Sets up guarantor accounts in Epic by determining if charges are considered personal/family, auto, worker's comp, etc., and adds insurance information into Epic by determining the relationship of the patient to the subscriber.
- Fills out claim information record for every charge submitted in Epic and verifies patient insurance by electronic submission through Epic checking website or by contacting insurance company via telephone.
- Determines if patient was an emergency admit, hospital to hospital transfer, or an endovascular case for statistical database.
Requirements
- High school diploma or equivalent and five years of experience in professional medical coding, with experience in two or three clinical specialties.
- Appropriate college coursework or vocational/technical training may substitute at an equivalent rate for the required experience.
- Certified Professional Coder (CPC)/American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required.
Preferred Qualifications
- Knowledge of medical terminology, surgical coding.
- Knowledge of business and office practice.
- Knowledge of Excel, and other applicable software.
- Ability to analyze financial data and generate understandable reports.
- Ability to communicate effectively, verbally and in writing.
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