Coder Asst

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.

Requirements
MINIMUM EDUCATION REQUIRED:

High School Diploma/GED required.

MINIMUM EXPERIENCE REQUIRED:

Healthcare experience preferred.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:

None

ADDITIONAL PREFERRED QUALIFICATIONS:

None

KEY RESPONSIBILITIES:

1. Evaluates medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the visit.

2. Compiles paperwork, including EOBs, notes, COB forms, etc. for coding review and/or mailing.

3. Ensures demographic information and documentation are congruent with scheduled or performed procedures.

4. Prints and sorts claims, as necessary, to improve coding workflow.

5. Monitors unbilled accounts, and escalates as appropriate.

6. 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.

7. Notifies appropriate individuals of potential non-compliance with medical necessity requirements and when services are non-covered or not payable, as appropriate.

8. Maintains established productivity and accuracy/quality standards.

9. Maintains organized, timely and current filing system for both paper and electronic records.

10. Completes other duties as assigned by Coding Supervisor

KNOWLEDGE, SKILLS, ABILITIES

 Basic knowledge of ICD-9-CM/ICD-10-CM and CPT coding principles and guidelines.

 Basic knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system.

 Basic knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to medical documentations, billing and coding.

 Basic knowledge of Standards of Ethical Coding.

 Skill and ability to communicate effectively both orally and in writing.

 Skill and ability to research and analyze medical record information, draw conclusions, and resolve issues.

 Ability to exercise independent judgment

 Skill and ability to maintain working relationships with physicians and other staff.

 Skill and ability to review the work of others and maintain confidentiality.