Job Description

Accurately assigns diagnosis and procedure codes to all applicable healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs. Reviews claims data to ensure that assigned codes meet required legal and regulatory requirements and that required signatures and authorizations are in place prior to submission. All Team Members of Southeast Georgia Health System will promote a culture of safety, follow established policies, and adhere to all state and federal regulatory requirements and national patient safety standards.

Essential Responsibilities: This description of job responsibilities is intended to reflect the major responsibilities and duties of the job, but is not intended to describe minor duties or other responsibilities as may be assigned from time to time.

• Identifies and codes all patient records, maintaining a 96% accuracy rate.
• Demonstrates understanding of policies, procedures, and federal guidelines that apply directly to coding and other work performed in this position.
• Effectively monitors billing reports to avoid inappropriate delays in coding and billing.
• Effectively communicates current and revised coding changes and clarifications to CHSI Medical Staff and Professional Billing Manager.
• Conducts medical records research and corresponds with insurance companies and healthcare professionals to resolve the issue if a claim is denied due to incorrect coding.
• Actively participates in the ongoing education of ancillary staff and healthcare providers regarding coding regulations.
• Responsible for monitoring the accounts not selected for billing report to avoid inappropriate delays in coding.
• Works with Cooperative Healthcare Services, Inc. physician practices in the review and correction of claims that fail the pre-billing editing screens.
• Stays abreast of current ambulatory surgery coding, billing, and reimbursement issues.
• Actively participates in ongoing education opportunities related to role and responsibilities.
• Responsible for monitoring the accounts not selected for billing report to avoid inappropriate delays in coding.
• Works with Cooperative Healthcare Services, Inc. physician practices in the review and correction of claims that fail the pre-billing editing screens.
• Stays abreast of current ambulatory surgery coding, billing, and reimbursement issues.
• Actively participates in ongoing education opportunities related to role and responsibilities.

Minimum Qualifications:

Education

High school diploma or equivalent, Medical Terminology Class, Anatomy & Physiology Class

Experience

1 Year Ambulatory Surgical and Physician Professional Coding experience

Licensure

Credentialed Coding Professional, RHIA, RHIT, CCS, CPC, CCS-P

Knowledge/Skills/Abilities

Positive interpersonal communication skills.

Demonstrates a cooperative attitude by being tactful and sensitive while using sound judgment when relating to others.

Proficient use of computer.