Brown Medicine
Salary
$24 - $39 / HOUR
The Coding Specialist reviews outpatient clinical documentation to assign appropriate ICD-10-CM and CPT codes, ensuring that the documentation supports the code assignment. They also monitor uncoded reports and resolve coding conflicts to maintain timely coding and billing processes.
Candidates must have a high school diploma or equivalent and successful completion of a formal coding educational program. A coding certification from AHIMA or AAPC is required, along with one to two years of experience in outpatient coding or billing.
Enters codedbstracted information into 3M 360 Finder assigning accurate APC and reviewing all coding edits appearing in 3M. Understands and follows all National Correct Code Initiative Edits (NCCI) and follows pertinent medical necessity requirements. Resolves accounts on the claims edit database. Assigns injections and infusion codes for observation patients. Meets the minimum productivity standard mintaining an average accuracy rating of 95%. Assigns E/M, ICD-10-CM, CPT or chargemaster codes to clinic visits ensuring medical record documentation supports the code. Should physicians have entered in diagnosis, ICD or CPT codes, ensures they are accurate and supported by documentation in the medical record. Utilizes 3M to identify and resolve NCCI edits before final billing. Reports documentation insufficiencies to the responsible physician. Follows Rhode Island Hospital Facility Coding Guidelines for adult patients and 1995 Evaluation and Management Guidelines for patients less than 18 years of age. Monitors and resolves rejected accounts on the Claims Edit Report and e Clinical Works error reports by established timeframe researching coding conflicts including chargemaster, medical necessity and various other coding and billing issues. Refers complex coding issues to the coding validator or supervisor. Reviews pertinent outpatient uncoded reports researching and resolving old uncoded accounts and any accounts posted on report for which the charges are inappropriate. Updates patient financial accounts in the Patient Management and Patient Accounting billing system as required. Follows established procedures for rebilling accounts. Performs related clerical duties as required. Maintains level of knowledge and expertise pertinent to the position.
BASIC KNOWLEDGE: High school diploma or equivalent. Successful completion of formal coding educational program. Ability to read and understand outpatient clinic medical record documentation for reporting of outpatient clinic, ancillary and endoscopies. Coding certification required from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). EXPERIENCE: One to two years experience in outpatient coding or billing. Ability to meet and maintain established quality and productivity standards. WORKING CONDITIONS: Requires long periods of sitting to review medical records. Ability to lift a minimum of 25 pounds, bend, stoop, stretch, use step-stools to file records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy. INDEPENDENT ACTION: Performs independently within the department’s policies and practices. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required. SUPERVISORY RESPONSIBILITY: None Pay Range: $24.29-$40.07 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
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