JOB PURPOSE
- Ensuring medical billing and insurance carriers pay and process claims correctly through coding the proper and appropriate medical codes (ICD-10, CPT).
KEY RESPONSIBILITY AREAS (KRA)
- Summary read and review patient medical records in order to summarize in alpha numerical codes the physician work performed, patient diagnosis and other information and codes required. Codes are applied in accordance with USA government, industry and company procedures, laws and regulations.
- Abstract and codes diagnoses, operations, procedures, physicians and payor classes from health records by using appropriate classification systems, standards and procedures
- Assigns patients severity of illness index ratings, supplemental codes and other data as necessary
- Compiles information and data from health records, internal and CPT guidelines, as well as computer systems for use in the evaluation of quality of care and utilization review
- Confers with supervisors to assure complete, current and accurate records
- Operates computer to process, store and retrieve health information.
GENERAL RESPONSIBILITIES
- Ensures strict confidentiality of clients, patients, and financial records to comply with PHI, ePHI and HIPAA
- Review, acceptance, and understanding of workplace culture statement
- Responsible to comply with organization's policies and procedures, adhere to Code of Conduct
- Ensures to complete the required compliance training modules and report any observations of non-compliance
- Other duties that may be assigned