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 qualified seminars, workshops and conference as required by AAPC
and/or AHIMA to maintain qualified certification(s).