CODER ANALYST SPEC-CLNIC

Overview Coder Analyst Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group Overview: Covenant Medical Group is the employed and managed medical practice organization of Covenant Health , providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and enters data from the medical records in order to maintain a database for statistics and reporting. Assists the Billing Department in timely billing and rebilling of patient information. Responsibilities - Reviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities. - Verifies data in the medical record and accurately abstracts pertinent information for charge entry. - Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal procedure(s) and related diagnosis. - Edits unbilled claim transmission reports daily and makes necessary corrections to ensure accuracy and timely billing. - Participates in quality coding and audit reviews for each provider. - Assists provider with coding questions for all services rendered. - Assists other coders with coding questions to determine the most appropriate codes used for billing compliance and refers coding questions to the Operations Manager when additional research is needed. - Contacts physicians for clarification and medical necessity. - Reviews all encounters for accurate documentation and coding of services rendered. - Communicates pending items and questions with office manager, CDI supervisor, and manager. - Demonstrates ability to meet or exceed practice quality and quantity standards. - Liaison between practice specialty and insurance company for benefit determination and claim rejections. - Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested. - Performs other duties as assigned. Qualifications Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Professional coding experience is preferred. Minimum Experience: Three (3) years of extensive diagnosis and procedural coding experience required. Licensure Requirement: Must have and maintain a CPC coding certification through the American Academy of Professional Coders, or be registered as a Health Information Technician (RHIT) through the American Health Information Management Association. Originally posted on Himalayas