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The coder is responsible for accurately assigning ICD-10 and CPT codes to hospital dictation and charge slips while managing patient demographic data. They also handle charge posting, resolve coding issues within the Athena system, and ensure compliance with insurance and legislative guidelines.
Primary Duties: Primary job duties include, but not limited to;
* Obtains hospital dictation and charge slips from physicians/hospital/transcription/Athena to code. Update physician coding as appropriate to payor guidelines. Utilization of proper ICD-10 and CPT codes.
* Responsible for verifying and updating all patient demographic information before posting charges on patient accounts. Creating new patient accounts when required. Obtaining demographic and authorization information from facilities.
* Responsible for coding and posting charges accurately and timely, including comment entries for global period, correct codes with proper modifiers and pricing. Correct coding in all procedure entry fields to ensure accurate tracking for reporting purposes. Accessing multiple software programs for processing accurate coding.
* Completing missing slips daily, verifying posting of all surgical appointments.
* Responsible for printing a daily schedule to ensure all cases are posted.
* Missing Slip Report run periodically to verify all scheduled surgeries posted for the month.
* Comparing pre-certed codes to documentation and notifying providers to authorize code changes. Upon physician approval, notify precert staff to change codes accordingly with various insurance carriers. Be sure all have precert/authorization attached to claims.
* Responsible for recording and balancing all posted charges, daily.
* Assists with coding questions from other departments, offices, and patients. Including fees for self-pay patients/down payments/Medicare rates.
* Posting prepays to surgery charges.
* Handling Athena worklist/scrubs on various coding issues such as improper diagnosis, medical necessity, missing or incorrect modifiers, assistant surgeons, appeals, etc. Must review documentation to update coding as documented.
* Correction of charges to other insurance carriers as requested and verified, including moving charges, payments, and adjustments.
* Auditing E/M documentation for all physicians.
* Various reports.
* Responsible for remaining current with state and federal legislative changes that affect outcomes. Posting staff should be familiar and up to date with all coding rules.
* Responsible for maintaining accreditation and or licensing in chosen field.
* Maintaining yearly courses for Healthstream.
* Maintains strictest confidentiality.
* Performs related work as required.
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