Job Responsibilities
Review and validate coding for Surgery and Emergency Department encounters.
Perform charge capture validation and revenue leakage analysis.
Review and resolve claim edits and coding denials.
Validate CPT, HCPCS, ICD-10-CM codes and modifier assignments.
Review NCCI, MUE, LCD/NCD edits and payer guidelines.
Conduct documentation audits and compliance reviews.
Collaborate with Coding, Billing, CDI, and Operations teams to maximize reimbursement and coding accuracy.
Identify process improvement prospects and provide coding education where required.
Required Specialties
General Surgery
Orthopedic Surgery
Neurosurgery
Vascular Surgery
Cardiovascular Surgery
GI Procedures
Urology
ENT
Emergency Department (ED)
Observation Coding
Critical Care Coding
Revenue Integrity Reviews