Medical Charge Processor - AMAC

JOB FUNCTIONS

• Review charge documentation from the clinic and/or hospital
• Accurately assign diagnosis and enter procedure codes into billing system using ICD-10-CM, CPT-4, HCPCS and other appropriate coding systems
• Perform regular auditing of coding throughout the practice, communicate findings to management, and provide recommendations based on the audit findings
• Communicate effectively with physicians and staff regarding correct coding and documentation processes
• Review daily reports for coding exceptions and follow up as required
• Work with A/R team on follow up and resolution of coding related denials and rejections
• Monitor professional publications, payer publications, and websites to remain up to date on coding changes relevant to the practice and communicate as necessary
• Confirm patient demographic, insurance and referring physician information is accurately entered into medical management system
• Confirm insurance verification and authorizations, as required
• Communicate with Accounts Receivable Specialist regarding insurance authorizations
• Review daily physician schedules and evaluate office consults and office visits for appropriate complexity using CPT coding guidelines
• Enter all CPT and ICD-10 into the practice management system for charge processing
• Respond to audit findings and make applicable coding additions or corrections
• Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates
• Update computer system and note section in patients account with any changes made to patient information or as otherwise dictated by company policy and procedure
• Confirm all appropriate charges are received and completed each week, and meets required regulations
• Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations
• Other projects as assigned

REQUIREMENTS

• Certified Coder, e.g., CPC, CCS-P, or ROCC
• Knowledge of coding including CPT-4, HCPCS II, and ICD-10-CM
• Minimum of three years of coding experience in a healthcare setting
• Ability to understand and interpret clinical documentation and follow the department billing processes at a detailed level
• Excellent verbal and written communication skills
• Must be detail-oriented and able to meet targeted deadlines
• Experience with Microsoft Office

Preferred Experience

• Knowledge of radiation oncology coding
• Centricity Practice Solution experience preferred

EDUCATION/CERTIFICATIONS:

• High school diploma or equivalent required
• Certified Coder, e.g., CPC, CCS-P, or ROCC