Coder Analyst Spec-Clnic

Covenant Health • Knoxville, TN

5d

About The Position

Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. The organization includes more than 300 physicians and advanced practice providers across 20 communities, with services spanning primary care, walk-in clinics, preventive medicine, surgery, and subspecialty care.

The Coder Analyst Specialist analyzes medical-record documentation to obtain information needed to sequence and assign ICD-10-CM and CPT-4 codes. The role abstracts and codes procedures in conjunction with providers, enters medical-record data for statistics and reporting, and supports timely patient billing and rebilling. The position is full-time on the day shift.

Requirements

• At least three years of extensive diagnosis and procedural coding experience.
• Must maintain 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.
• Education may be satisfied by any combination of formal education and/or prior work experience demonstrating the knowledge, skills, and abilities needed for the role, typically equivalent to a high school diploma or GED.

Nice To Haves

• Professional coding experience is preferred.

Responsibilities

• Review medical-record documentation to determine ICD-10-CM and CPT-4 coding needed to comply with government billing and reimbursement guidelines.
• Verify medical-record data and accurately abstract pertinent information for charge entry.
• Apply current CPT-4 and ICD-10 procedural coding standards while assisting providers with selection and assignment of principal procedures and related diagnoses.
• Edit unbilled claim transmission reports daily and make corrections to support accurate, timely billing.
• Participate in quality coding and audit reviews for each provider.
• Assist providers with coding questions for services rendered.
• Assist other coders with coding questions, identify appropriate billing-compliance codes, and refer questions requiring additional research to the Operations Manager.
• Contact physicians for clarification and medical necessity.
• Review encounters for accurate documentation and coding of services rendered.
• Communicate pending items and questions to the office manager, CDI supervisor, and manager.
• Meet or exceed practice quality and quantity standards.
• Serve as a liaison between the practice specialty and insurance companies for benefit determinations and claim rejections.
• Follow policies, procedures, and safety standards.
• Complete required annual education assignments.
• Work toward goals and objectives and participate in quality-improvement initiatives as requested.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED