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- Knowledge of CPT, ICD10, and HCPCS coding
- Knowledge of Medical Terminology & Anatomy
- Identify ICD 10 Codes as appropriate per CCI Guidelines
- Ability to process charges through the electronic health record
- Ability to work denials through multiple systems
- Ability to explain the differences between correct coding and payer requirements
- Ensures claims are submitted proper and timely by the provider and include the necessary modifiers and units
- Ability to differentiate place of service between inpatient, outpatient, and observation
- Identify coding trends for education and reports to Supervisor
- Identifies trends with insurance related issues and reports to Supervisor
- Ability to abstract appropriate CPT and ICD10 from medical record
- Reviews and corrects issues, rejections and/or denials for place of service and CPT mismatches, pre and post op denials, missing diagnosis, age related, and modifiers
- Knowledge of Medicare Annual Exams vs. Preventative visits
- Proficiency in NDCs and Infusion drugs
- Policy research to ensure correct coding
- Knowledge of CMS guidelines, complying with medical coding guidelines and legal requirements to ensure compliance with federal and state regulations
- Various duties as assigned by Manager and/or Supervisor
- CPC Certification a must
- Minimum of 2 - 5 years of medical coding experience required
- Experience in Surgical coding preferred, but not required
- Strong written and verbal communication skills
- Ability to set and meet deadlines
Medical Coder - Morristown, United States - Atlantic Health System
Description
The medical coder, under the supervision of Manager of AMG (Atlantic Medical Group, our physician practices) Revenue Cycle, will play a key role in supporting the billing office operations. Addresses inquiries from the CBO team regarding the billing, coding, and claims submission process as it relates to coding rules and payer requirements.
Qualifications for Internal Candidates