Physician Coding A/R Specialist- General surgery
1 month ago
Department:
10417 Revenue Cycle - Coding & HIM Support ProfessionalStatus:
Full timeBenefits Eligible:
YesHou rs Per Week:
40Schedule Details/Additional Information:
General surgery or trauma experience preferred.
General Surgery or Trauma exp needed
Major Responsibilities:
In collaboration with Customer Service, analyze and resolve professional coding complaints in a timely manner using correct coding and payer guidelines to ensure patient satisfaction. Identifies and analyzes coding denials for a specific population of charges and works in collaboration with the Production Coding team. Coordinates coding rejection data collection activities used for reporting and accountability tracking. Identifies potential trends or knowledge concerns and opportunities for improvement and prevention. Researches and documents applicable regulatory, coding and billing rules. Develops standardized processes and tools for the coding production team to utilize when dealing with insurance rejections and recommendations to avoid future denials. Works with Professional Coding Leadership to develop monthly coding update reports to continually educate and communicate coding related recommendations based on monthly findings. Maintains up-to-date information regarding coding denials and rejections and communicates the changes accordingly. Identifies and problem solves trends and issues. Collaborates with department leadership clinic operations managers, system contracting team to determine preventative measures, follow-up and resolve these issues. Communicates with and acts as a resource for others regarding coding and appeal issues. Provides regular statistical reports to leadership regarding rejection/denial volumes, response timeliness, success rates, identified trends, and recommendations to prevent future coding rejections/denials. Maintains up-to-date knowledge of Medicare, Medicaid and other regulatory requirements pertaining to nationally and locally (i.e., NCD, LCD) accepted coding policies and standards. Develops expertise in coding for assigned specialties. Communicates and reinforces changes in CPT, ICD-10-CM/PCS, HCPCS and other requirements and coordinates necessary modifications and updates appropriately. Responsible for retrospective chart and claim coding review. Identifies coding errors and recommends correct coding based on CPT, ICD-10 CM/PCS, HCPCS in accordance with coding and payer guidelines.
Licensure, Registration, and/or Certification Required:
Education Required:
Experience Required:
Knowledge, Skills & Abilities Required:
Physical Requirements and Working Conditions:
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