At the direction of the Manager, assume responsibility for coding audit activities for provider groups assigned to the team.
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Coordinates and conducts audits for documentation of coding in assigned clinical sections.
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Coordinates coding feedback of documentation review results in on-going written communication for providers.
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Monitors provider documentation and coding in all professional and hospital outpatient settings.
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Responds to questions regarding coding and documentation practices. Conducts process evaluation and researches topics and develops education plan.
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Researches issues related to coding and documentation practices. Develops communication and distribution strategies.
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Evaluates and recommends possible changes to coding or documentation practices.
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Assimilates information; identifies key issues, and presents pertinent information to the team.
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Identifies coding trends through data analysis and assists in the evaluation of coding data with team.
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Coordinates response to compliance concerns through management.
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Participates in the development of new coding policy.
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Maintains membership in professional organizations, attends conferences and workshops and relationships with payors. Ensures that current information is secured, maintained and distributed to providers.
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Applies mandated coding guidelines to documentation, including E/M code assignment, auditing and education.
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Performs other duties as required or assigned.
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High school graduate with 4 years of coding experience required.
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Previous experience in abstracting for coding in professional and hospital outpatient areas like E&M, ED and OR preferred.
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Strong organizational and analytical skills with the ability to effectively communicate, both orally and in writing with all levels of staff.
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Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), or Certified Coder Specialist-Physician Based (CCS-P) certification required.