- Call insurance companies about denials
- working denials using multiple applications, Epic, Hyland, IDX web and term, E-browser, Med-assets, Siemens, and SSI
- CPT-4, ICD-9 and medical terminology
- fax and scan documentation
- review claims, UBO4, and EOB
- writing appeals
- Records after payment, calculating charges for patients developing invoices for patient and insurance companies.
- use of diagnosis and procedure codes
- Inbound/outbound calls
- ICD-9, CPT-4 and HCPCS codes
- verify insurance payments and adjustments
- verify location of services SBD/OBD
- Approval for authorization forms
- Data entry
- review medical records
- Communication with accounting office/coder
- Emergency room Remote coder
- Review medical records to resolve Ingenix coding edits
- coding related edits by reviewing the medical record and ensuring that all data and codes are consistent with ICD-9-CM official guidelines, CPT Assistant, and CMS
- correct data as appropriate
- review medical records to identify diagnosis procedures
- verifies and abstracts all medical data from the record to assign appropriate codes for the following settings hospital emergency and inpatient. organizes and prioritizes all work to ensure that records are coded, and edits are resolved, in a timeframe that will assure compliance with regulatory, billing and requirements, Completeness of medical record data. Confidentiality/security of systems
- Provides feedback to monitor service provider and line of business compliance with regulatory requirements.
- Ensures timely data completion by meeting coding/abstracting productivity/quality standards established for the professional service coder .
- Traveling medical coder-Emergency room
- ability to read and abstract office notes and procedure notes to apply correct ICD-9,CM,CPT-4, HCPCS LEVEL 2 and modifier coding assignments.
- E M both the 1995 and 1997 documentation guidelines
- rules and regulations of Medicare billing including but not limited to, teaching situations, shared visits ,consultations and global surgery.
- coding of surgical procedures performed by ED physicians
- coding of moderate sedation and time based coding
- medical terminology, anatomy, and physiology
- Medical coder -psychiatry specialty-inpatient
- Translates and Transforms medical diagnoses, procedures, and injuries into designated numerical International Classification of Diseases ICD codes on claim forms, and on numerous medical records.
- Uses coded data for quality assurance activities, case-mix management, and other administrative, and research activities.
- Analyzes medical records, and assigns codes to classify diagnoses, and procedures to support the reimbursement system, provide support assessment of clinical care, and to support medical research activity.
- Reviews, screens, and analyzes inpatient, and outpatient records for compliance with established criteria.
- Works collaboratively with patient account department to ensure accurate billing.
- Maximizes reimbursement by ensuring accurate ICD-9-CM, HCPCS, and CPT-4 coding.
- Rapidly mastered Soft Med and ClinTrac Clinical Abstracting and 3M clinical encoders' software for fast, accurate coding and abstracting. Builds mutually respectful relationships with third-party payers, HMOs, PPOs and Medicare, Medicaid, the time of discharge Workers' Compensation WC carriers and independent commercial carriers.
- Ensures records met quality and risk-management requirements by participating in hospital chart review committee.
- Level 3 coder-emergency room/outpatient
- Translates/Transforms medical diagnoses, procedures, and injuries into designated numerical International Classification of Diseases ICD codes on claim forms, and on numerous medical records.
- Medical terminology, anatomy, and physiology
- Analyzes medical records, and assigns codes to classify diagnoses, and procedures to support the reimbursement system
- . Reviews, screens, and analyzes inpatient, and outpatient records for compliance with established criteria. .
- Uses coded data for quality assurance activities, case-mix management, and other administrative, and research activities