Responsible for converting and auditing physician and APP documentation of diagnoses, procedures, and utilized supplies and devices into appropriate codes using ICD-10, CPT, and HCPCS guidelines. Reviews physician and APP coding and billing processes for accuracy and to ensure optimal reimbursement. Acts as a coding resource for providers and clinic managers. Collaborates with the follow-up team to overturn denials and avoid future denials.

• High school graduate or equivalent.

• Coding certification: CPC, CCS, or CCS-P

• Fully knowledgeable of, and conducts all activities in accordance with regulatory compliance requirements, including but not limited to HIPAA rules and regulations, Medicare Secondary Payer Screening requirements, medical necessary screening and ABN rules, Red Flag Rules, and billing and coding compliance rules and regulations.

PREFERRED

• Associate/Bachelor's Degree or actively pursuing advanced degree.

• Previous physician office and/or hospital coding experience and demonstrated knowledge of coding procedures and claim review and analysis strongly recommended.