Familiarity with medical coding guidelines (ICD-9-CM, CPT, HCPCS, UHDDS, HIPAA)
Willingness to pursue continuing education and maintain knowledge of CPT/HCPCS/ICD coding changes
Ability to use web-based tools and multiple information systems to gather, verify, and enter patient demographic and billing information
Requirements:
Review and verify assigned codes (diagnosis and procedures) and abstract accurate clinical information to ensure precise coding for reimbursement; contact physicians for clarification as needed
Maintain up-to-date knowledge of coding and regulatory requirements and pursue continuing education to stay current with CPT, HCPCS, and ICD changes
Use web-based tools, coding books, and multiple information systems to gather demographics, insurance, and encounter information; perform manual charge entry and ensure accurate, timely data entry and billing
Participate in audits to capture lost charges; respond to inquiries from provider offices and internal departments; create EPIC registrations when necessary to record encounters and bill stakeholders
Job description
Essential Functions/Competencies:
Reviews and verifies assigned codes and sequences diagnosis and procedures according to regulations (e.g., ICD9CM, CPT, HCPCS, UHDDS, and HIPPA coding guidelines) and abstracts accurate clinical information to obtain the most specific code possible to ensure an accurate health information database.
Contacts physicians for clarification of clinical information as appropriate for account type as necessary
Maintains up-to-date knowledge of coding and regulatory requirements to accurately assign codes for appropriate reimbursement of healthcare services. Continue to strive to meet continuing education requirements for certification or to maintain working knowledge of on-going changes to CPT, HCPS, and ICD codes
Utilize web-based tools, coding books, and other available resources to facilitate providing insurance companies with required information.
Utilize multiple information systems to accurately select the correct patient account in order to appropriately review and verify patient billable charges.
Participate in and assist with audits to capture lost charges and determine the accuracy of billing as necessary.
Gathers demographic, insurance, and health care encounter information from a variety of sources for the purpose of billing medical provider professional fees.
Enter and verify the appropriate demographic information, charges, and comments into the computerized billing system.
Perform manual charge entry by gathering demographic, insurance, and healthcare encounter information from a variety of sources in order to accurately bill medical provider professional fees.
Ensure information entered in the system is done in an accurate and timely manner. Verifying charges on accounts as needed and providing detailed and accurate comments for future reference.
When necessary, create a registration in the appropriate system (EPIC) from documentation provided to accurately record encounter and accurately bill the appropriate stakeholders.
Responds to inquiries from provider offices and various internal departments in a timely and accurate professional manner.
