Description 1. Determines appropriate assignment of CPT, DSM-5, and ICD codes for physician, therapist, and facility services provided in an outpatient and inpatient settings.

2. Evaluates medical record for consistency and adequacy to prove medical necessity.

3. Researches, analyzes, and updates codes, as needed, in billing software in a timely manner to maintain prompt billing compliance.

4. Ensures all patient visits are coded in accordance with Centers for Medicare and Medicaid Services (CMS), CPT, DSM-5 and the Correct Coding Initiative (CCI) guidelines.

5. Performs chart audits for assigned providers and provides documentation and audit feedback to providers.

6. Performs insurance verifications to ensure accuracy of coding in electronic record.

7. Corrects codes, as needed, in billing software in a timely manner to maintain prompt billing compliance.

8. Conducts quality assurance audits and incorporates quality assurance information, findings and feedback into coding processes.

9. Identifies trends, recommends, and implements solutions for inaccuracies with coding; monitors for changes in trends related to the coding process affecting coding, charge entry, and billing.

10. Communicates with and assists in coding education of providers and support staff.

11. Provides orientation and training to new providers on coding and documentation guidelines and re-education as needed.

12. Serves as a resource to providers and support staff; interacts with all levels of personnel on coding issues.

13. Performs data reporting and statistical tracking.

14. Maintains a resource center regarding coding education for providers.

15. Participates in department meetings and interdisciplinary meetings.

16. Establishes and maintains effective working relationships with other employees, clients, other agencies, and the general public. Requirements 3M, 3m Coding, Allscripts, Armed Forces Health Longitudinal Technology Application (AHLTA), Cerner Technologies, Auditing, Billing Functions, Charts - Graphs, Claim Administration, Clinical Trial Operations, CPT Codes, Dsm-Iv, Centers for Medicare & Medicaid Services (CMS), ICD Codes, ICD Codes TalentMatch®

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