CODER ANALYST SPEC-CLNIC

Covenant Health•Knoxville, TN

About The Position

The Coder Analyst Specialist analyzes medical-record documentation to obtain the information needed to sequence and assign ICD-10-CM and CPT-4 codes. The role abstracts and codes procedures in conjunction with providers, enters data from medical records for statistics and reporting, and assists the Billing Department with timely billing and rebilling of patient information. The position is full time, 80 hours per pay period, on the day shift.

Requirements

  • At least three years of extensive diagnosis and procedural coding experience.
  • Must maintain either CPC coding certification through the American Academy of Professional Coders or registration as a Health Information Technician (RHIT) through the American Health Information Management Association.
  • No specific minimum education is stated; an equivalent combination of formal education and/or prior work experience demonstrating the required knowledge, skills, and abilities is acceptable, 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 meet government billing and reimbursement guidelines.
  • Verify medical-record data and accurately abstract pertinent information for charge entry.
  • Apply CPT-4 and ICD-10 coding standards to assist providers in selecting and assigning 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 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; work toward goals and objectives; and participate in quality improvement initiatives as requested.
  • Perform other duties as assigned.
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