Job Description

Summary:

In accordance with current federal coding compliance regulations and guidelines, use current ICD-10-CM/PCS, CPT-4, and HCPCS code sets/systems to accurately abstract, reconcile and review procedure and physician documentation in order to code, and enter into PBAR, Cerner or other electronic medical billing systems. Understands coding/billing computer systems in a manner to assure bills drop timely with appropriate codes. Meet the productivity and accuracy/quality standards including, but not limited to 98% of CCL charges entered into the electronic medical billing system within 3 days of date of service. Work collaboratively with physicians, staff and management to identify opportunities for improving charge capture, accuracy and timeliness of entry into electronic billing systems. Recommendations for staff education and process improvement will be escalated to the CCL Manager.

Minimum Education/Experience:

Specialized/Technical Training - Graduation from a formal coder training program or completion of academic class in medical coding. (Combined experience/education as substitute for minimum education.)

2+ years with hospital coding or charge audit expertise

Combined experience/education as substitute for minimum education. *Two additional years of coding experience may be substituted for education requirement.

Primary Accountabilities:

Support Soarian Financials Billing Edits and Billing Processes

Reviews and reconciles procedure documentation with supply charges and physician documentation

Partner with staff and physicians to correct inaccuracies in HCPCS, ICD-10, CPT coding to accurately capture services provided

Enters Cardiac Cath Lab procedure and supply charges into electronic billing systems (PBAR)

Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate review of ICD10 and/or CPT code assignments with physician.

Reviews, reconciles and corrects Cardiac Cath Lab charges in Cerner

Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes.

Provides completed patient data to billing staff or designated personnel.

Performs other duties as assigned.

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