This position is a Medical Coder I in our AHSIC division.
• Coordinates, schedules, performs the professional services documentation and coding audits of outpatient, procedures and testing records for AHP.
• Evaluates the quality of clinical documentation to identify incomplete or inconsistent documentation that could impact the quality of data being reported.
• Audits codes and professional fee services performed by providers from medical records according to ICD-10, CPT, HCPCS, and CMS guidelines.
• Responsible for maintaining up to date knowledge of coding guidelines as they relate to professional services.
• Develop and coordinate educational and training programs regarding elements of coding such as appropriate documentation, accurate coding, coding trends found during chart reviews, third party audit findings, and annual coding updates.
• Evaluates and provides appropriate documentation for the third party payer CPT denials to maintain the original CPT assignment, and when necessary, implement corrective action plan and/or educational programs to prevent similar denials and rejections from recurring.
• Meets with the providers to review the audit findings and to recommend ways to improve when indicated.
• Orients and trains new providers throughout the year.
• Audit charts for accurate and correct coding and compliance within documentation guidelines and AHP/AHS policies.
• Prepares written reports of the audit findings by provider/practice.
• Follows up with providers as needed until documentation improves.
• Assists with claim denial reports to ensure optimal reimbursement.
• Serves as a resource to the office staff, providers, and billing department.
• Provides clarification on AHP coding and compliance policies.
• Other duties as required at the discretion of the manager/director.
• Create invoices for submission and resolve billing issues that may arise.
• Provide regular reports and to include accounts receivables, statistics, analysis of invoices and tracking reports at regular intervals.
• Maintain Client Directory and update regularly.
• Provide reports that assist with client communication.
• Oversee, maintain and submit deposit logs.
• Review and ensure all office patients have accurate registrations in EPIC/Zotec and adjust any improper billing accordingly and communicate errors with staff.
• Assist patients, families and clients with billing assistance as needed.
• Communicate with physician and staff on pertinent issues.
• Error correction and staff retraining as needed.
• Implement and manage system upgrades.
• Assist in the strategy on Workers compensation and Occupational Health Service line.
• Assist in the process of tracking downstream revenue from AAUC.
• Enhance AHP departments by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job and accomplishments.
HS Diploma required
2 years of relevant medical coding experience.
An AAPC certification
Atlantic Health System aims to deliver the highest quality, safety and care combined the best experience for our patients and their families. We are confident that you will find success within Atlantic Health System, which has been named for the 14th year in a row to Fortune’s “Top 100 Best U.S. Companies to Work For” list. We believe you will find that our culture of collaboration and care exemplifies the value we place on our patients, their families and our employees.
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.
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