JOB DESCRIPTION: Responsible for coding and abstracting diagnoses utilizing ICD-10 coding conventions, reviewing physician documentation for completeness and accuracy to ensure proper code assignment, making system updates to resolve billing edits and releasing encounters for billing. Reviews schedules, orders, and medical record documentation for coding purposes to identify missing charge information. Thorough understanding of the coding process. Makes decisions, responds, and forwards information in an appropriate manner regarding medical record documentation.
Duties include:
* Evaluates medical record document for coding and abstracting diagnoses utilizing ICD-10-CM coding conventions for all diagnosis related edits, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper assignment of diagnosis codes, entering updates in the practice management system to resolve edits and releasing encounters for billing to efficiently perform tasks and meet production and quality standards.
* Compiles paperwork, including EOBs, notes, COB forms, etc. for coding review and/or mailing.
* Ensures demographic information and documentation are congruent with scheduled or performed procedures. Prints and sorts of claims, as necessary, to improve coding workflow.
* Ensures demographic information and documentation are congruent with scheduled or performed procedures.
* Queries physicians when code assignments are not straightforward or documentation is inadequate, ambiguous, or unclear for coding purposes; offers physician opportunity to submit corrected documentation.
* Notifies appropriate individuals of potential non-compliance with medical necessity requirements and when services are non-covered or not payable, as appropriate.
* Maintains organized, timely and current filing system for both paper and electronic records.
* Works independently to resolve issues, applying root cause analyses to determine steps required for timely resolution.
* The ability to communicate effectively and professionally in interactions with customers, management, and peers. Must be able to work collaboratively and positively within a culturally diverse production environment. Proficiency in healthcare insurance billing, reimbursement, and coding guidelines.
* Perform other duties as required.
MINIMUM QUALIFICATIONS: A high school diploma or equivalent. One (1) year experience in healthcare related accounts receivable role or 6 months of Professional Coding experience. Working knowledge of ICD-9-CM/ICD-10-CM and CPT coding principles and guidelines, Standards of Ethical Coding, and medical terminology, anatomy, and physiology.
PREFERRED QUALIFICATIONS: Knowledge of GE Centricity Business Practice Management billing system and related modules. Knowledge of EPIC EeMR. Moderate analytic skills. |
Emory is an EEO Employer-Disability/Veteran. Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. |