Make Your Dream Job Your Reality
- Provide client services and lead, coordinate, and perform all functions of quality reviews for outpatient coding across multiple clients.
- Performs quality reviews on coders ensuring compliance with coding guidelines and company policies for complete, accurate, and consistent coding.
- Reviews include Outpatient ICD-10, CPT, APC, CPT Modifiers, ED E&M and professional coding and E&M assignments.
- Knowledge expert and maintains up-to-date working knowledge of coding guidelines in order to act as a resource and point person for issues and question for coders, customers or project teams.
- Provides education to audit clients or internal eCatalyst coders as required by the deliverables of the contract.
- Reviews physician documentation for coding appropriateness and accuracy following coding guidelines.
- Facility OP auditing including Same Day Surgery, Observation, ED, and Ancillary visit types. Profee multi-specialty experience is a plus.
- Provides feedback to coders and providers on coding corrections, appropriately citing authoritative resources.
- Assists with the interpretation of codes and other information requested for accurate code assignment.
- Communicate with management regarding clinical, coding, and reimbursement issues as needed.
- Function in a professional, efficient, and positive manner with strong critical thinking and decision-making skills.
- Utilizes our client’s electronic medical record (EMR), encoder, and computer-assisted coding (CAC) software as directed.
- Ensures optimal reimbursement while maintaining compliance with CMS and third-party payor policies and guidelines.
- Maintains compliance with client’s coding policies, procedures, and guidelines.
- Consistently maintains 95% or above accuracy rate while meeting established productivity standards.
- Completes daily production log and daily time keeping requirements.
- Attends and participates in client meetings as requested.
- Completes coding continuing education and maintains auditing credentials.
- Ensures HIPAA compliance at all times.