Archbold Medical Center - Thomasville, GA
posted about 2 months ago
Responsible for developing, implementing and managing a centralized program to promote greater efficiency with completing, tracking, and reporting coding and retro audit reviews to determine the appropriate appeal of patient accounts. Combines clinical, business, and regulatory knowledge and skill to reduce significant financial risk and exposure caused by denial and audit of claims billed for rendered services. Through continuous assessments, problem identification, and education, this individual facilitates the quality of health care delivery in areas of inpatient coding, DRG, outpatient, professional coding, medical necessity, government, and commercial payer requirements. Furthermore, the individual routinely analyzes data related to payer audit and denial trends specific to coding-denial and takeback concerns. This position works closely with HIM and CDI as well as key stakeholders across Revenue Cycle.