Provider Based Coding Analyst I

Responsibilities

• Performs ICD-10-CM and HCPCS/CPT-4 coding for 1-2 Tier 1 specialties
• Enters a variety of data such diagnoses, procedures, E/M levels, and modifiers into the hospital information system
• Adheres to coding principles, governmental regulations, and third party requirements in regards to coding and billing documentation
• Reviews and resolves relevant edits to ensure accuracy and integrity of info billed to payers
• Achieves and maintains established quality standards
• Achieves and maintains established productivity standards
• Provides feedback to providers; makes recommendations to improve medical record documentation
• Meets turnaround time requirements
• Monitors assigned work queues and alerts manager if lag days exceed established standard
• Works with coding manager to ensure maximum reimbursement for properly documented services

Requirements

• Associate's Degree in a healthcare related field or coding curriculum
• Less than 1 year of experience in multi-specialty
• Knowledge and understanding of medical terminology
• Knowledge and understanding of provider based billing processes and workflows
• Knowledge of human anatomy and physiology and disease processes
• Skilled in collecting and analyzing complex data
• Proficient, functional use of Current Procedural Terminology (CPT) and ICD-10-CM and HCPCS
• CCA - Certified Coding Associate AHIMA - State of Pennsylvania within 1 year or CCS - Certified Coding Specialist AHIMA - State of Pennsylvania or CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania or CPC - Certified Professional Coder - State of Pennsylvania or CPC-H - Certified Professional Coder-Hospital AAPC - State of Pennsylvania