POSITION SUMMARY:##Responsible for reviewing medical records and translating the information about the patient#s visit in to codes for insurance carriers to process claims. # MINIMUM QUALIFICATIONS:# # Evaluates medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit. # # Interacts with physicians and other patient care providers in coding admission, principle, and secondary diagnoses and coding principal and secondary procedures to promote appropriate reimbursement. # # Interacts with the Insurance Department for timely processing of claims. # # Abstracts diagnoses and procedures from medical record into the Physician Health Information System for timely billing. # # Evaluates medical records and charge tickets to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-10-CM), and the American Medical Association#s Current Procedural Terminology manual (CPT). # Provides technical guidance and training on medical coding to physicians and staff. # Performs within the prescribed limits of the hospital#s/department#s Ethics and Compliance program. Detects, observes and reports compliance variances to the department director or upward through the chain of command, the Compliance Officer, or hospital hotline.# # Performs related duties as required # Required:# # High School Diploma or equivalent.# # Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), or other coding certification. # Preferred:#Experience in coding for physician and/or provider practice locations and services based on Medical Records documentation. # Some on-location meetings are required -#for example, training and IT updates.## #############################################