Under general supervision, the Medical Coder I is responsible for abstraction of medical record documentation to ensure timely and accurate coding of all medical services utilizingÂ CPTÂ andÂ ICD-10, and has general knowledge ofÂ CMSÂ and Third Party Payer billing rules.
Reviews medical record to evaluate accuracy of codes for medical billing and to ensure that all services have been captured for timely filing of medical claims to payers; applies general knowledge ofÂ CMSÂ regulations and third party payer guidelines to apply correct coding practices to medical claims.
Responds to Third Party Request for information and documentation needed to process billing and handle claim denials.
Evaluates and researches coding edits that applied to claims that are suspended for medical coding edits; corrects medical coding in order to clear coding edits and generate accurate medical claims.
Utilizes reconciliation tools to ensure capture of all hospital and ambulatory services for medical billing; researches missed encounters and reviews medical record to extract and code for missed services.
Periodically meets with internal compliance and physicians to review documentation and answer coding questions.
Performs other duties as assigned.
Knowledge, Skills, and Abilities
Working knowledge of medical billing and coding utilizingÂ CPT,Â ICD-10, andÂ HCPCS
Working knowledge of medical terminology
Knowledge ofÂ CMSÂ documentation and billing regulations
Ability to efficiently operate computer software for Electronic Health Record and Practice Management Systems
Ability to evaluate system edits for appropriateness of coding and apply appropriate third party payer rules
Ability to maintain confidentiality
Interpersonal/human relations skills
Verbal and written communication skills
Ability to manage multiple tasks
High school diploma; Associates degree preferred. RequiresÂ AAPCÂ specialty-specific coding credentials (applicable for appropriate department assignment), orÂ AAPC-CPCÂ orÂ RHITÂ certification.
Saint Louis University(SLU) is a private, co-educational Jesuit university located in St. Louis, Missouri, United States. Founded in 1818 by the Most Reverend Louis Guillaume Valentin Dubourg SLU is the oldest university west of the Mississippi River. The University has campuses in St. Louis, Mo. and Madrid, Spain. SLU values academic excellence, life-changing research, compassionate health care, and a strong commitment to faith and service. For nearly 200 years, the University has gone beyond teaching facts and figures, encouraging students to form ideas and identities. Today, SLU students are nearly 14,000 strong. The University has invested vast resources to advance academic programs and enhance the student experience. SLU also is a major research institution where premier researchers tackle local and global challenges. And the University's commitment to community service has earned it national acclaim and bolstered its status as a character-building college.