Review medical records and assign or validate accurate CPT, HCPCS, and ICD-10 codes, modifiers, and units for professional services, with a focus on neurosurgery and possible orthopedic coverage. Resolve coding inquiries and claim edits, educate providers on coding and documentation, and meet accuracy and productivity standards.
The Clinical Data Specialist is responsible for the abstraction, analysis, and reporting of quality indicators to improve patient care outcomes. They must also build collaborative relationships and maintain accountability for performance and professional growth.
The specialist manages accounts receivable functions including billing, claim corrections, and payment posting to ensure financial accuracy. They also provide feedback on claim denials and maintain professional operations to maximize patient satisfaction.
The role is responsible for the abstraction, analysis, and reporting of quality indicators to improve patient care and outcomes. It involves investigating internal and external initiatives to enhance healthcare processes.
