CODER ANALYST SPEC-CLNIC

Covenant Health•Knoxville, TN

About The Position

The Coder Analyst Specialist analyzes medical-record documentation to obtain information needed to sequence and assign ICD-10-CM and CPT-4 codes. The specialist abstracts and codes procedures in conjunction with providers, supporting correct coding for services rendered, and enters data from medical records into databases used for statistics and reporting. The role also assists the Billing Department with timely billing and rebilling of patient information.

Requirements

At least three years of extensive diagnosis and procedural coding experience.
Must hold 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.
Education is not specified; an equivalent combination of formal education and/or prior work experience sufficient to demonstrate the required knowledge, skills, and abilities is accepted, typically equivalent to a high school diploma or GED.

Nice To Haves

Professional coding experience is preferred.

Responsibilities

Review medical-record documentation to determine the 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.
Use current 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 code selection for billing compliance 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 with 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 regarding 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.