Austin, Texas
Gaffney, South Carolina
Fort Wayne, Indiana
San Jose, California
Ennis, Texas
3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and outpatient cases. Reviews coding insurance denials and refers clinical coding denials to the CDI Physician Advisors.
4. Resolves insurance denials that have been accepted by updating the coding and send for rebilling if required.
5. Generate coding appeals for insurance denials with sound arguments and based on coding guidelines and conventions.
6. Generates coding appeals as a result of CDI Physician Advisor reviews suggesting appeal. Coordinates Peer to Peer requests with third party payers and CDI Physician Advisors and prepares for meeting.
7. Researches and resolves problems referred by coders and provides prompt feedback.
8. Provides input on performance of coders and audit information to supervisor for performance evaluations.
9. Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
10. Provides training and serves as a general resource to assist other coders and members of department staff.
11. Provides training to Physicians, non-physician providers and their support staff on coding guidelines and conventions.
12. Participates in and provides education sessions as needed on specific coding topics at huddle meetings and other forums.
13. Reviews, analyzes and abstracts physician/other documentation for diagnoses, procedures, ancillary testing, medications, laboratory and other services provided.