Coding & Reimburs Spec

Texas Tech University Lubbock, TX
Reviews official medical records with physician/healthcare provider documentation and assigns appropriate codes for all physician/healthcare provider services from current editions of official coding sources. Ensures accurate, complete, and timely code assignments for all physician/healthcare providers. Major/Essential Functions

* Payment reallocation report, copay report, patient report, self pay report.

* Worker's Compensation. Keep a file on each patient. Obtain letters of Medical necessity, when requested, to insurance companies or maybe an attorney. Obtain proper information to patients' employers for benefits. Set up appointments for impairment ratings and functional capacity evaluations and send a letter to remind patients and insurance company of appointment. Follow through with evaluation and proper physician signature in order to respond back to the insurance company and place original in patient's chart.

* Enter charges into IDX for clinic visits and procedures; hospital surgeries, e/m, admits, consults, rounds.

* Research/correspondence on surgery dictation and SOI.

* Work ETM denials for referring MD or DOI, DDO.

* Pre-certs.

* Upload TCN.

* TES edits/minimal coding.

* Emails for ER to OR patients.

* Patient Satisfaction.

* Perform other related duties as required.

Required Qualifications •A minimum of a high school diploma or equivalent plus at least two (2) years of coding and reimbursement experience that includes procedural and diagnosis coding. OR •A minimum of a high school diploma or equivalent plus successful completion of a recognized procedural and diagnosis coding course. Preferred Qualifications Knowledge of the CPT, ICD-CM and HCPCS non-menclatures, coding rules and guidelines; knowledge of coding software applications, preferred; advanced understanding of medical terminology and body systems/anatomy and physiology and concepts of disease processes; knowledge of inpatient and outpatient medical records processing and federal and state reimbursement regulations. Dependable in both production and attendance. Excellent oral and written communication skills. Ability to write clear, concise reports, and business correspondence. Ability to read, analyze, and interpret professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of manager, clients, customers, and the general public. Strong problem-solving skills, self-starter, ability to function with only limited standardizations exists; ability to interpret a variety of instructions furnished in written, oral, diagram, or basic algebra. To perform this job successfully, an individual should have knowledge of Database software; Spreadsheet software and Word Processing software.

Coding assistance experience in a multi physician practice. Coding certification and/or training.

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