Job Description
Primary Purpose of the Position:
The Revenue Cycle Medical Coder II is responsible for assigning diagnosis, procedural, and modifier(s) codes for medical billing purposes which includes verification of charge capture. Position also performs a wide variety of duties, which may include coding accuracy and completeness prior to tickets being processed for billing, insurance filing, and revenue reporting. Monitors daily flow of charge tickets to ensure claim accuracy. This is not a Remote position as you will be expected to come into the Los Angeles Office.
Essential Duties of the Position May Include The Following:
• Reviews charge tickets, identifies and corrects errors, prepares tickets for review, including proper CPT and ICD-10 codes and proper linkage between the two.
• Abstracts all surgical and designated diagnostic procedures and assigns appropriate procedure codes and modifiers using the International Classification of Diseases (ICD-10) system, and the Physicians’ Current Procedural Terminology (CPT-4).
• Reviews and maintains Athena worklist claims on a daily basis.
• Consistently meets and exceeds daily productivity and quality standards.
• Effectively works on complex and escalated cases.
• Cross-trained; i.e coding different specialties.
• Reviews scanned paper charge tickets for accuracy and completeness of codes.
• Maintains and expands knowledge of Anatomy and Physiology, Pathophysiology, Pharmacology, and Medical Terminology as basic building blocks for ICD-10-CM coding.
• Compiles, reviews and performs data reports and other duties assigned by Management.
• Identifies trends and communicates to the management team with findings.
• Works and collaborates closely with Revenue Cycle Team Members, Clinician, Physician, Division Leadership and Management.
• Keeps current of coding requirements by reviewing payer guidelines and regulations.
• Maintains a log of coding errors and omissions for review with the management team.
• Stays current on coding and compliance regulatory requirements through professional membership literature, continuing education classes, support and networking groups.
• Maintains current knowledge of regulatory requirements by CMS NCCI and MUE edits, Medi-Cal/CCS policies, and certain Medicare requirements.
- Attends various meetings and professional development programs on a regular basis; makes recommendations for revisions and/or new departmental procedures under the direction of management.
• Maintains audit record systems for radiology department.
• Performs other related duties as assigned by Management.
Job Qualifications:
Knowledge and skill:
Pediatric Management Group manages 600+ physician academic practice affiliated with Children's Hospital Los Angeles.
Pediatric Management Group manages 600+ physician academic practice affiliated with Children's Hospital Los Angeles.
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