- Review medical documentation and assign appropriate E&MCPT; codes based on AMA and CMS guidelines
.
- Analyze Medical Decision Making (MDM), time-based services, and documentation
requirements.
- Review denied claims to identify root causes and determine corrective actions.
- Ensures project activities are in compliance with applicable coding guidelines,
government and federal regulations.
- Research payer policies and coding guidelines related to denials
- Ensure compliance with HIPAA, regulatory requirements, and client-specific guidelines.
- Maintain ongoing communication with management regarding coding workload,
turnaround time expectations and deliverables.
- Escalate complex coding or denial issues to leadership when necessary
- Maintains at least 95% accuracy in all coding projects by researching literature and
attending professional seminars, workshops and conference as required by AAPC
and/or AHIMA to maintain qualified certification(s).