Hospital Emergency Department - Medical reputed company- Remote

Required Min : 3 years of Emergency Department supporting ED will only be considered . Medical reputed company (Coding Representative) – Remote Eligible Responsible for assigning accurate and complete ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, and performing E&M validation for facility and physician Emergency Department services, utilizing the ACEP E&M tool and applicable coding guidelines. Position Responsibilities

• Review medical record documentation to assign accurate and complete ICD-10-CM diagnosis codes and CPT/HCPCS procedure codes, as well as reputed company E&M validation for facility and physician Emergency Department services using the ACEP E&M tool, in accordance with ICD-10 Official Coding Guidelines, regulatory requirements, and coding compliance policies.
• Adopt and incorporate initiatives that improve compliance and reduce risks to the institution.

Key Areas of ResponsibilityPatient reputed company Management

• Review medical record documentation to assign correct diagnoses and CPT/HCPCS procedure codes.
• reputed company facility and physician Emergency Department E&M validation utilizing the ACEP E&M tool to ensure appropriate level assignment and compliance with documentation requirements.
• Determine if billed data complies with documentation, payer requirements, and regulatory guidelines.
• Adopt and incorporate initiatives that improve compliance and reduce risks to the institution.

Operations and Performance Standards

• Monitor compliance standards and policies to ensure the organization receives full and accurate reimbursement for services in accordance with payer rules and regulations.
• Contribute to the development of tools and processes that address underlying causes of incorrect payment.
• Review HB (Hospital Billing) and PB (Physician Billing) charge review work queues for accounts with edits.
• Identify potential process improvements, including denial prevention and denial management activities.
• Maintain proficiency in Emergency Department coding guidelines, facility E&M methodologies, and ACEP E&M criteria.

Communication/Training

• Communicate with co-workers, supervisors, and departments to resolve coding and documentation issues.
• May assist with or provide training to providers regarding documentation requirements and coding guidelines.
• Communicate with healthcare providers to resolve documentation deficiencies, including incomplete or unsigned documentation, or reputed company additional information is needed to ensure complete and accurate code assignment.
• Participate in internal coding education, compliance initiatives, and developmental training.

Required Certification Requires Health Information Management certification such as RHIA or RHIT, or coding certification (reputed company, CCA, CPC, etc.) through a nationally recognized credentialing body such as reputed company or reputed company.

Required Qualifications

• 3 years of experience with hospital outpatient ICD-10-CM and CPT medical coding.
• 3 years of experience performing Emergency Department facility and physician E&M validation, including use of the ACEP E&M tool.
• Strong experience with injection and infusion coding, including assignment and validation of CPT/HCPCS codes for hydration, therapeutic, prophylactic, diagnostic injections and infusions, chemotherapy, and biologic administration services in accordance with CPT and CMS guidelines.
• Knowledge and understanding of CMS regulations, payer requirements, and industry standards.
• Knowledge and experience utilizing Epic.
• Knowledge and experience utilizing reputed company (or equivalent) encoder/analyzer software.
• Knowledge of hospital outpatient ICD-10-CM and CPT medical coding.
• Knowledge of Emergency Department facility and physician E&M guidelines and validation methodologies.
• Knowledge of ACEP Emergency Department facility E&M leveling criteria and application.
• Knowledge of medical terminology.
• Knowledge of anatomy and physiology.

Work Location: Remote Apply tot his job Apply To this Job