Pro-Fee Coder

Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures.

Duties and responsibilities

• Assigns required CPT/ICD/ASA/HCPCS codes and/or modifiers as needed per documentation Identifies missing information and gives to appropriate party for follow up Resolves TES edits as required.
• Select and sequence principal and secondary diagnosis and procedure codes.
• Assign appropriate APC.
• Review the medical record and all applicable documentation to determine the appropriate codes to assign for the services and diagnoses.
• Be knowledgeable of billing and coding requirements for governmental guidelines and private insurance payers.
• Abstract statistical data from the patient record and enter information following the facility guidelines.
• Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding for all of the assigned services.
• Review documentation of various providers to determine accurate coding for all medical services and surgical procedures from available medical records within electronic medical records.
• If the diagnosis is unclear prepare and assign queries following the facility guidelines for the query process.
• Determine all appropriate diagnoses and assign the most specific ICD-10 code.
• Assist other departments in coding and reimbursement issues.
• Follow all HIPAA regulations and uphold a higher standard around privacy requirements.
• Develop trusted relationships with the client contacts and other team members around the globe.
• Adhere to all internal competencies, behaviors, policies and procedures to ensure efficient work processes.
• Completes all assigned work in a timely manner based on internal, client and/or payer standards.
• Always maintain at least a 98% accuracy rate.
• Maintain productivity standards, tracking and deadlines.
• Maintain and complete accurate productivity and tracking logs.
• Keep all equipment updated and active on the internet.
• Comply with established facility policies and procedures.
• Other duties as deemed necessary by management.

Education and Experience

• At least 2 years of experience Anesthesiology Pro Fee Coding
• Credentials necessary (one of the following):
  - CPC, CCS-P, RHIT, RHIA