Coding and Documentation Review Specialist

Job Details: Responsible for the review of provider documentation and coding charge review errors as well as Evaluation and Management coding. Ensure that the coding is appropriate before releasing the claims to be billed. Identify trends and opportunities for improved documentation and billing and communicate those trends with the Coding Educators and providers. Must be fluent with the Evaluation and Management / CPT coding guidelines, ICD10 coding guidelines for outpatient, inpatient, observation coding including but not limited to all office-based services, procedural coding and hospital rounding.

DUTIES/RESPONSIBILITIES: Review documentation and coding for both inpatient and outpatient (hospital and office) professional services before the release of charges. Queries the provider of items in the chart that need to be reviewed or corrected as it relates to the coding selected. Responsible for monitoring regulatory changes as they apply to billing and coding in the inpatient and outpatient setting. Serves as resource to the practices/departments for data mining and coding to ensure reimbursement accuracy. Identifies coding issues related to billing denials, collaborates with the Coding Educator and Revenue Integrity as needed to assist with the preparation of training materials and examples to prevent future coding/billing issues. Accurately code CPT and diagnoses. Expected to maintain department productivity standards and accuracy rates.

POSITION REQUIREMENTS AND QUALIFICATIONS: Education: