• Processing patient data, including medical records and billing information • Submitting and tracking claims with insurance companies • Ensuring accurate and timely payment for healthcare services • Working closely with healthcare providers and insurance companies to resolve billing discrepancies • Verifying insurance coverage and processing payment posting • Attending daily meetings with reimbursement team member • Attending weekly team meetings, completing the to-do’s assigned to reimbursement team member • Preparing appeals to be sent by reimbursement representative • Reporting to reimbursement team member any item that is not resolved within a timely manner

• Reviews the documentation in the record to identify pertinent facts for coding • Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-10 code • Meets with physicians to review documentation and resolve coding issues • Assists with efforts to increase physician awareness of documentation requirements • Prepares case reports and initiates follow-up for the billing process • Conducts chart audits

• Assign ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility (Professional fee coding). • Review all applicable documentation of various providers to determine the appropriate codes to assign for all medical services, procedures, and diagnoses from available documentation within electronic medical records. • Ensures diagnosis codes meet local and national medical necessity guidelines. • Be knowledgeable of billing and coding requirements for governmental and private insurance payers. • Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding for all assigned services. • Demonstrates the technical competence to use the facility encoder and EMR in an office or remote setting. • Review and resolves coding edits and denials. • Assists with rebilling accounts when necessary. • Maintain a working knowledge of various laws, regulations and industry guidance that impact compliant coding. • Follow all HIPAA regulations and uphold a higher standard around privacy requirements. • Completes all assigned work in a timely manner based on internal and/or payer standards. • Must meet all coder productivity and quality goals; Maintain a 95% accuracy rate. • Attending and reporting at weekly team calls with Director of Medical Coding Compliance. • Reporting coding patterns identified within the coding process to management. • Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials. • Adhere to all internal competencies, behaviors, policies and procedures to ensure efficient work processes. • May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation. • Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance or Chief Compliance Officer.

• Review and abstract clinical documentation from patient records to assign accurate codes for diagnoses and procedures • Ensure compliance with federal regulations and hospital policies related to coding and billing • Maintain productivity and quality standards established by the HIM department • Query physicians when appropriate to ensure accurate and complete documentation • Assist in resolving coding-related billing issues or discrepancies • Maintain up-to-date knowledge of current coding guidelines, payer regulations, and industry best practices • Participate in internal audits and ongoing education for coding accuracy and compliance • Communicate effectively with physicians, clinical staff, and HIM leadership