CODER ANALYST SPEC-CLNIC

Covenant Health • Knoxville, TN

73d

About The Position

Coder Analyst Specialist, Clinical Document Integrity is a full-time position at Covenant Medical Group, which is part of Covenant Health's medical practice organization. The role involves analyzing medical documentation to ensure accurate coding of ICD-10-CM and CPT-4 codes, maintaining a database for statistics and reporting, and assisting the Billing Department with timely billing processes.

Requirements

• None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.
• Three (3) years of extensive diagnosis and procedural coding experience required.
• Must have and maintain a CPC coding certification through the American Academy of Professional Coders, or be registered as a Health Information Technician (RHIT) through the American Health Information Management Association.

Nice To Haves

• Professional coding experience is preferred.

Responsibilities

• Reviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities.
• Verifies data in the medical record and accurately abstracts pertinent information for charge entry.
• Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal procedure(s) and related diagnosis.
• Edits unbilled claim transmission reports daily and makes necessary corrections to ensure accuracy and timely billing.
• Participates in quality coding and audit reviews for each provider.
• Assists provider with coding questions for all services rendered.
• Assists other coders with coding questions to determine the most appropriate codes used for billing compliance and refers coding questions to the Operations Manager when additional research is needed.
• Contacts physicians for clarification and medical necessity.
• Reviews all encounters for accurate documentation and coding of services rendered.
• Communicates pending items and questions with office manager, CDI supervisor, and manager.
• Demonstrates ability to meet or exceed practice quality and quantity standards.
• Acts as a liaison between practice specialty and insurance company for benefit determination and claim rejections.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees