• Review specific visit types to confirm eligibility, verify place of service, appropriate coding and documentation. • Assign appropriate diagnosis codes using ICD-10-CM, and procedure codes using CPT and HCPCS. • Link proper diagnosis code with appropriate CPT code for billing purposes. • Identify and communicate documentation deficiencies to providers. • Submit statistical data with regards to weekly production. • Process clinical professional charges timely and accurately. • Review and process claim edits and clinical professional charges for insurance and coding accuracy and compliance.

• Reviews and accurately interprets medical record documentation from all hospital accounts • Identifies all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified • Codes the minimally complex patient classes • Assigns hospital codes to a variety of patient classes • Reviews charts and accurately determines the appropriate charges using charge tools, policies and procedures, and reference materials • Inputs charges into the billing system • Maintains productivity and accuracy standards according to departmental and hospital policy • Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas • Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals • Assures the accuracy, quality, and timely review of data needed to obtain a clean bill • Contacts physicians or any persons necessary to obtain information required to accurately code assignments

• Drop claims for office, hospital, nutrition, pathology, biologics, imaging, pediatricians, anesthesia, and endoscopy center for accurate processing by payers • Review medical documentation from EMR and hospital systems for accurate coding and billing to insurance companies • Apply current billing and coding guidelines • Evaluate that charges provided by the physicians support the level being billed based on the documentation • Prepare claims with necessary fields for processing, such as linking authorizations to charges, code blood work, and assigning appropriate modifiers as needed • Provide feedback to office managers and physicians regarding clinical documentation to ensure compliance with coding guidelines and reimbursement reporting requirements • Manage claims for auditing purposes, including placing them on hold and billing once the process is complete • Email office managers and physicians where updates are needed to operative reports

• Perform at an advanced level medical coding position • Utilize ICD-10 and CPT4 classification system coding to all diagnoses, treatments and procedures • Provide coding insight and guidance to clinical staff, CDI, Professional Coder 1 and 2 positions, as well as Revenue Cycle leadership • Assign and sequence all ICD-10; CPT 4; Healthcare Common Procedure Coding (HCPC) and modifier codes • Reconcile correct coding edits and discrepancies prior to final coding • Maintain coding quality of 95% or higher while meeting established productivity requirements • Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations • Identify trends in documentation deficiencies and communicate areas of improvement opportunities to leadership and/or providers • Act as a mentor to Coder I and Coder II staff • Provide system and workflow training to newly employed coders • Prepare and present education in conjunction with the Revenue Integrity Professional Coding Educator • Act as back up for Revenue Integrity Professional Coding Lead