The coder is responsible for assigning accurate ICD-CM, CPT, and HCPCS codes to professional encounters while ensuring compliance with documentation standards. They also interact with medical staff to clarify documentation and resolve rejected or denied encounters to optimize reimbursement.
The RN is responsible for obtaining prior authorizations for medications and procedures by coordinating with insurance companies, patients, and healthcare providers. They also document approval statuses and resolve denial issues to ensure patients receive necessary care.
The role involves assigning facility charge codes and modifiers for emergency department records to ensure optimum reimbursement. It also requires monitoring accuracy metrics and coordinating with medical staff to obtain necessary documentation.
