•Analyses and interprets patient medical records and assigns and sequences appropriate diagnostic/procedure billing codes in compliance with documentation and of third party payer requirements. •Assist with the performance of clinical reviews with knowledge of body systems, anatomy and physiology. •Review medical policies to indicate a clinical bases for medical necessity. •Dissect and deduce patient medical records to identify and determine amount and nature of billable services. •Interacts with providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation. •Generates reports from eCW for assigned projects.
•Requires certification in ICD-9CM and CPT Coding (CPC, CCS-P) from an accredited agency. And annual CEU’s to maintain certification. •Work requires minimum of 5 years of prior experience in a hospital and/or medical setting. E&M and procedural coding experience required. •Working knowledge of governmental (CMS) and third party regulations required, as well as a high degree of analytical ability of medical charge interpretation. •Experience in coding and chart analyses for the abstraction of medical records documentation. Knowledge of physicians billing required. •Experience navigating insurance company web sites. •Basic knowledge of Microsoft Excel, Word and Outlook. •Detail oriented with solid problem solving and investigative skills. •Ability to work and thrive under pressure while handling multiple priorities and meet deadlines. •Must be able to work with multiple levels of the organization. •A willingness to assist with a variety of company projects as needed