Denials Coder

Job Summary

Graduation, life science background preferably Biochemistry, Microbiology, Physiotherapist, Pharmacy and Nursing. - Minimum of 2 year of experience with profound foundational knowledge in Denial coding. - Should be CCS, CPC, RHIA or RHIT certified from AHIMA/AAPC. - Software/Platform Preference-Working experience in Meditech, 3M 360, CAC would be added advantage. - Strong anatomy & physiology knowledge. Knowledge Type US Culture & Geography Essential Healthcare Domain Knowledge Essential Reading and understanding of EOB Desired Revenue Cycle Management Essential Skill Type Good Computer Skills, Typing, keyboard Essential Internet Skills Essential Attention to details Essential Good Comprehension Skills Essential Attributes Type Career Stability Desired Health Desired Adherence to policies and procedures Essential

Responsibilities

• Accurately code services through review of medical record documentation and encounter forms.
• Assign/Edit ICD-10 diagnosis codes, and modifiers based on documentation, government teaching physician documentation requirements and LCD/NCD/ NCCI policies.
• Should be an expertise in reviewing CPT/ ICD codes and resolving the respective edits
• Understand the client requirements and specifications of the project
• Ensure that deliverable to the client is adhered to the quality and productivity standards
• Review and analyze clinical records to ensure that APC assignments accurately reflect the diagnoses documented in the clinical record.
• Ability to read handwritten and transcribed documents in the health record, interpret information and enter complete accurate data into a computer system
• Comprehensive knowledge of medical diagnostic and procedural terminology is required
• Understanding of disease process, anatomy, and physiology necessary for assigning accurate numeric and alpha-numeric codes
• Ensure that deliverable to the client is adhered to the quality (95%) and productivity standards from the Marietta Client Profile.
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses and procedures selected.
• Complete assigned work functions utilizing appropriate resources.
• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
• Maintain strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release of information.
• Support Savista s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient and/or client information.

Qualifications

• Should be CCS, CPC, RHIA or RHIT certified from AHIMA/AAPC.

Requirements

• Graduation, life science background preferably Biochemistry, Microbiology, Physiotherapist, Pharmacy and Nursing.
• Minimum of 2 year of experience with profound foundational knowledge in Denial coding.
• Software/Platform Preference-Working experience in Meditech, 3M 360, CAC would be added advantage.
• Strong anatomy & physiology knowledge.
• Knowledge Type US Culture & Geography Essential Healthcare Domain Knowledge Essential Reading and understanding of EOB Desired Revenue Cycle Management Essential Skill Type Good Computer Skills, Typing, keyboard Essential Internet Skills Essential Attention to details Essential Good Comprehension Skills Essential Attributes Type Career Stability Desired Health Desired Adherence to policies and procedures Essential

Skills

• ICD-10 coding
• CPT coding
• Denial coding
• Meditech
• 3M 360
• CAC
• EOB reading
• LCD/NCD/NCCI policies
• HIPAA Privacy and Security Regulations

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