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CPSI

Coding Advocate

Posted 2 days ago
2-5 years experience
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AI Summary

The Coding Advocate is responsible for performing medical coding and data abstraction for various hospital visit types including inpatient, outpatient, and emergency services. They must ensure accurate code assignment, review claims for medical necessity, and maintain compliance with regulatory standards.

The Coding Advocate will handle medical coding and data entry / abstraction for various types of Hospital visits: Inpatient, Outpatient, Ambulatory, Surgery, Emergency and Special Procedures.

These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required.  Goals and objectives are subject to change.

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate. 

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

  • Inpatient: Accurately assigns ICD-10-CM and PCS primary and secondary diagnoses and procedure codes based on the documentation in the record and in accordance with the site specific guidelines and policies.  Accurate assignment of the DRG.
  • Outpatient: Correctly assigns modifiers to chargemaster items and coder assigned CPT codes as applicable to outpatient coding, as appropriate.
  • Outpatient Surgery: Correctly assigns CPT codes to outpatient procedures consistent with client contract and documentation in the record.
  • Emergency Room: Correctly assign diagnosis codes, assign appropriate E&M facility and/or profee levels, assign infusion and injection CPT codes.
  • Ability to create compliant physician queries.
  • Accurately review claims for medical necessity.
  • Update problem lists consistent with client contract.
  • Correctly assign present on admission indicators.
  • Ability to provide excellent customer service to our clients and teammates.
  • Consistently demonstrates an excellent attitude, and works to strengthen the team as a whole.
  • Floats between multiple sites, and coding specialties with ease and flexibility.

Minimum Requirements:

Education/Experience/Certification Requirements

  • 2 year degree or equivalent experience; AHIMA or AAPC certification required
  • Actively holds one or more of the following credentials: RHIA, RHIT, CCS, CPC, COC
  • Minimum of 1 year experience coding
  • Meets or exceeds Quality and Productivity standards.
  • Excellent communication (written and oral) and interpersonal skills.
  • Strong organizational, multi-tasking, and time-management skills.
  • Must be detail oriented and able to follow through on issues to resolution.
  • Must be able to act both independently, and as a team member.
  • Excellent communication (written and oral) and interpersonal skills.
  • Strong organizational, multi-tasking, and time-management skills.
  • Must be detail oriented and able to follow through on issues to resolution.
  • Must be able to act both independently and as a team member.

Preferred Qualifications:

  • 2+ years of coding experience in multiple patient types
  • Experience coding and charging injections and infusions
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