Outpatient Claims Coding Specialist
2 weeks ago
Focus on outpatient coding, primarily for emergency department claims.
The role involves meticulous examination of accounts, verifying charges, and ensuring accuracy by applying modifiers when necessary.
Responsibilities include:
- Correcting and validating charges.
- Addressing billing edits returned by the billing team.
- Collaborating with Health Information Management (HIM) and Nurse Audit teams.
Key Edits to Manage:
- CCI: The CCI Mutually Exclusive Code Edits highlight codes that cannot be performed concurrently. An example is the simultaneous reporting of an "assessment" service and a "reassessment" service.
- NCD: National Coverage Determinations (NCD) coding modifications may arise from new codes, revisions, or feedback, included in quarterly ICD-10 updates.
- NCCI: The National Correct Coding Initiative (NCCI) implements checks to prevent erroneous payments and improper coding practices in healthcare billing. NCCI edits may encompass Procedure-to-Procedure (PTP) edits and Medically Unlikely Edits (MUEs).
Utilizing EPIC to manage the backlog from the work queue.
Qualifications:
- Minimum of 2 years of coding experience required.
- Experience in outpatient coding is essential.
- Proficient understanding of modifiers and their application.
- Familiarity with NCD, NCCI, and CCI edits is necessary.
As partners in transformation, we assist clients in activating innovative ideas and solutions to seize new opportunities. Our team of 80,000 collaborates with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe, and Asia. As a leader in Full-Stack Technology Services and Talent Services, we work alongside progressive leaders to drive impactful change. This is the essence of true partnership. TEKsystems is part of the Allegis Group.
TEKsystems is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.
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