Medical Coding Specialist for Audits Compliance

Medical Coding Specialist for Audits & Compliance
Job Description
Duties:
Chart Review & Analysis: Carefully go over doctor's notes and electronic health records (EHR) to find all recorded procedures and diagnoses.
Code Assignment: Give precise HCPCS Level II, CPT, and ICD-10-CM codes.
Assign Diagnosis Related Groups (DRG) for hospital stays and Ambulatory Payment Classifications (APC) for outpatient visits appropriately.
Compliance & Auditing: Make sure that all codes are backed up by clinical documentation by closely adhering to HIPAA regulations and Official Coding Guidelines.
Physician querying: To guarantee coding specificity, send expert queries to healthcare professionals when documentation is unclear, lacking, or contradictory.
Denial Support: Work together with the billing and AR teams to provide coding explanations or updated codes in order to address Medical Necessity denials.

Focus Skills:
Mastery of Anatomy and Physiology: In-depth knowledge of medical pharmacology, disease processes, and human bodily systems.
Code Set Expertise: Understanding the hierarchical structures and protocols of CPT and ICD-10-CM/PCS.
Analytical Thinking: The capacity to combine intricate clinical data and use reasoning to choose the most precise code.
Software Proficiency: Knowledge of EHR systems and computer-assisted coding (CAC) tools.
Ethical Standards: A strong dedication to Coding Integrity—refraining from upcoding or unbundling in order to increase reimbursement.

Apply now to become an integral part of our growing team!
With Regards,
HR - Maria
88708 33430
infohrmaria04@gmail.com