Description :

1. Reviewed and coded medical records for various specialties, including Neurology and Internal Medicine.
2. Conducted internal audits to ensure compliance with E&M documentation standards.
3. Collaborated with the reimbursement team to address and resolve payer discrepancies.
4. Analyzed accounts receivable and identified trends in claim denials to enhance department performance.
5. Provided coding recommendations to management for process improvements.
6. Participated in training sessions to educate staff on updates in coding standards.
7. Maintained up-to-date knowledge of coding guidelines and payer policies.

Experience

0-2 Years

Level

Entry Level

Education

AAS

Description :

1. Performed comprehensive coding for outpatient and inpatient procedures, ensuring compliance with current regulations.
2. Reviewed and analyzed operative notes and pathology reports to ensure accurate coding.
3. Managed invoicing for surgical procedures, applying charges accurately to patient accounts.
4. Scheduled and coordinated inpatient and outpatient surgeries efficiently.
5. Conducted internal audits for coding accuracy for multiple physicians.
6. Responded to inquiries from healthcare providers regarding coding and billing processes.
7. Provided coding guidance to peers and external healthcare facilities.

Experience

0-2 Years

Level

Junior

Education

AAS in Med Coding

Description :

1. Conduct thorough audits of medical records to ensure compliance with ICD-10 coding standards and federal regulations.
2. Utilize ICD-10 and CPT coding systems to accurately assign diagnosis codes based on clinical documentation.
3. Perform risk adjustment validation audits to verify coding accuracy and compliance with CMS guidelines.
4. Review claims submitted to identify discrepancies and ensure adherence to coding guidelines.
5. Assist in developing training materials and conducting sessions for staff to improve coding accuracy and compliance.
6. Support daily operations of the coding department, ensuring timely and accurate coding for all medical records.
7. Provide technical assistance to medical staff regarding coding inquiries and software issues.

Experience

5-7 Years

Level

Senior

Education

AAS HIT

Description :

1. Preview all insurance claims to ensure accuracy, compliance, and conformity with AMA, CMS, AAPC, and payer-specific guidelines for over 250 providers.
2. Develop and maintain code for software applications and systems.
3. Appeal denied or improperly bundled claims to maximize reimbursements.
4. Respond promptly to internal and external inquiries regarding coding practices.
5. Collaborate with cross-functional teams to define project requirements.
6. Attend payer meetings to discuss updates and changes in coding regulations.
7. Perform chart audits to verify that medical record documentation supports billed codes.

Experience

7-10 Years

Level

Management

Education

AAS

Description :

1. Reviewed and verified accurate coding for ICD-9, ICD-10, and CPT code sets.
2. Maintained current knowledge of CPT, ICD-9, and HCPCS coding standards.
3. Audited and reconciled patient accounts to ensure billing accuracy.
4. Managed uncollectible accounts, reviewing them for service dates, authorizations, and codes.
5. Processed insurance and patient claims in a timely and precise manner.
6. Conducted monthly quality audits for compliance with federal regulations.
7. Collaborated with insurance carriers to resolve outstanding claims and denials.

Experience

5-7 Years

Level

Senior

Education

AAS

Description :

1. Deliver comprehensive coding and auditing services across various medical specialties, ensuring compliance with ICD-10 and CPT coding standards.
2. Analyze clinical documentation to accurately translate medical diagnoses and procedures into designated codes.
3. Conduct thorough documentation assessments to ensure regulatory compliance and accurate reflection of services provided.
4. Implement software solutions based on user feedback and testing.
5. Expertly code for multiple specialties, including Internal Medicine, Orthopedic Surgery, and OBGYN, ensuring precision in all coding endeavors.
6. Maintain up-to-date knowledge of coding regulations and guidelines to uphold compliance and accuracy.
7. Assess provider documentation to determine appropriate Evaluation and Management (E&M) levels, ensuring correct coding practices.

Experience

7-10 Years

Level

Consultant

Education

AAS

Description :

1. Conducts thorough reviews and codes medical records for accuracy in billing and compliance.
2. Abstracts and verifies CPT-4, HCPC II, and ICD-10 CM codes from clinical documentation.
3. Processes charge documents efficiently in the billing system to ensure timely submissions.
4. Resolves complex coding scenarios and denials through diligent research and communication.
5. Provides coding guidance to physicians and practice management to enhance documentation quality.
6. Collaborates with accounts receivable teams to address coding-related denials and rejections.
7. Stays current with coding regulations and best practices to ensure compliance and accuracy.

Experience

0-2 Years

Level

Entry Level

Education

AAS-HIT

Description :

1. Accurately completed claims paperwork, ensuring all documentation met coding standards.
2. Effectively coded and billed medical claims across various specialties, maintaining high accuracy.
3. Proactively researched new diagnoses and medical procedures to enhance coding skills.
4. Identified and rectified discrepancies in medical documentation to ensure compliance.
5. Kept updated with coding requirements through ongoing education and certification renewals.
6. Efficiently entered orders into EMR systems with zero errors.
7. Assigned medical codes with a 98% accuracy rate, ensuring optimal reimbursement.

Experience

7-10 Years

Level

Management

Education

A.A.S. HIT

Description :

1. Assist healthcare professionals and patients by resolving billing issues and correcting insurance denials.
2. Conduct audits on submitted claims to ensure compliance and maximize reimbursements from payors.
3. Maintain a compliant coding environment by adhering to federal and state regulations.
4. Review and resubmit claims using accurate codes to ensure optimal reimbursement.
5. Oversee hospital charge processing to maintain current coding practices.
6. Communicate with insurance companies to address coding discrepancies and facilitate resolutions.
7. Utilize Practice Management systems to gather necessary documentation for claim submissions.

Experience

0-2 Years

Level

Junior

Education

AAS

Description :

1. Managed a diverse portfolio of medical records, ensuring accurate coding and compliance.
2. Collaborated with healthcare providers to clarify documentation and coding discrepancies.
3. Maintained up-to-date knowledge of coding guidelines and changes in regulations.
4. Assisted in the training of staff on coding protocols and compliance measures.
5. Participated in quality assurance initiatives to improve coding accuracy.
6. Provided support to billing teams to ensure timely claims submissions.
7. Utilized coding software and databases to track and analyze coding trends.

Experience

0-2 Years

Level

Fresher

Education

AAS

Description :

1. Coded patient claims using ICD-10 and CPT codes for a busy practice with multiple healthcare providers.
2. Collaborated with insurance companies to resolve claim issues, ensuring timely payments.
3. Identified and corrected coding errors that led to payment delays, improving cash flow.
4. Utilized Meditech and online resources to verify coding accuracy and compliance.
5. Generated detailed reports on billing trends to assist management in decision-making.
6. Proactively followed up on unpaid claims, achieving a high success rate in dispute resolution.
7. Maintained coding accuracy by staying updated on changes in coding standards and regulations.

Experience

0-2 Years

Level

Entry Level

Education

AAS

Description :

1. Reviewed medical record documentation to accurately assign codes for diagnoses and services using ICD-10, CPT, and HCPCS systems.
2. Ensured compliance with inpatient and outpatient coding guidelines through detailed documentation analysis.
3. Determined Diagnosis-Related Groups (DRGs) based on assigned codes to facilitate accurate billing.
4. Evaluated discrepancies in medical records and confirmed coding accuracy.
5. Facilitated coding decisions among team members by providing resources and support.
6. Recommended solutions in accordance with CMS and organizational policies.
7. Participated in administrative meetings to discuss coding standards and improvements.

Experience

0-2 Years

Level

Junior

Education

AAS HIT

Description :

1. Develop unit tests and automated testing frameworks for code.
2. Analyze user requirements and translate them into technical specifications.
3. Established positive relationships with healthcare providers and clinical staff.
4. Coordinated medical necessity documentation for outpatient testing.
5. Maintained a coding accuracy rate exceeding 98% for ICD-10, CPT, and HCPCS coding.
6. Achieved daily production goals while exceeding quality standards.
7. Assisted in internal audits of coding records to identify and correct inaccuracies.

Experience

0-2 Years

Level

Entry Level

Education

AAS-HIT

Description :

1. Managed outpatient accounts daily, leveraging HIMD edit report data for accuracy.
2. Analyzed health information management to enhance revenue cycle communication.
3. Consistently met departmental productivity standards for coding efficiency.
4. Collaborated with directors to optimize procedures for compliant orders and coding access.
5. Identified key abstractable information from physician orders for accurate coding.
6. Entered essential data into Meditech for billing and statistical tracking.
7. Reduced unbilled outpatient accounts from $6 million to $74,000 by month-end.

Experience

0-2 Years

Level

Entry Level

Education

AAS

Description :

1. Maintained a 50 chart productivity rate while ensuring compliance with coding standards.
2. Reviewed health risk assessments to verify completion and adherence to CMS guidelines.
3. Assessed the accuracy and specificity of diagnosis codes, improving coding precision.
4. Provided recommendations for coding policy improvements based on regulatory updates.
5. Maintained comprehensive knowledge of Medicare Risk Adjustment coding procedures.
6. Identified discrepancies in health risk assessments, leading to improved coding accuracy.
7. Ensured compliance with HIPAA regulations for all coding activities.

Experience

5-7 Years

Level

Senior

Education

AAS HIT

Description :

1. Utilized CPT, ICD-9, ICD-10, and HCPCS codes to ensure accurate coding and compliance prior to submission to insurance.
2. Engaged with physicians for additional information to improve coding accuracy and completeness.
3. Successfully passed the ICD-10 certification examination.
4. Maintained proficiency in EMR systems, Microsoft Office, and Epic, fostering a collaborative environment with managers.
5. Assigned ICD-10 CM and CPT procedure codes for emergency room encounters, ensuring compliance with coding standards.
6. Reviewed and validated emergency room documentation for completeness and accuracy, supporting high-quality patient care.
7. Proactively queried providers for clarification on documentation, enhancing coding precision.

Experience

5-7 Years

Level

Senior

Education

AAS HIT