The primary function of this role with be to communicate with providers through the third-party portal on

documentation needs for radiology. This position needs an understanding of radiology coding and billing. This

employee must have complete knowledge of all E/M leveling of care in both Ambulatory and Acute setting.

Have confidence in accuracy coding for billing. The ability to meet internal productivity standards.

Maintain the relationship between the providers and the portal for our third-party radiology

billing company.

· Provide physicians and clinicians with education on radiology documentation

· Communicate with the physician and audit this information to improve errors

· Timely responses to third party biller to update needed documentation

· Update manager of issues with portal and any issues that arise with third party radiology

  group

· Review medical records and provider documentation for ambulatory services.

· Assign appropriate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS Level II.

· Ensure coding accuracy and adherence to CMS, AMA, and payer-specific guidelines.

· Resolve coding edits and discrepancies in collaboration with billing and clinical teams.

· Maintain a coding error rate that meets on audited records.

· Participate in coding quality reviews and training sessions.

· Stay current with coding updates, regulations, and best practices.

· Attend compliance and billing meetings as required.

Education

Possession of coding certificate through a credited school. (Computer classes, Anatomy, Coding courses, etc.)

Minimum Work Experience

One-year coding experience is highly recommended

Required Skills, Knowledge, and Abilities

Dependent upon level of expertise defined in the Education/Training section: Maintains a working knowledge of coding fundamentals: ICD—10CM coding for inpatient and outpatient physician services; CPT/HCPCS coding for surgical procedures, for physician services; and CPT/HCPCS coding, namely Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Association’s Coding Clinics, and/or American Medical Association’s CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled nursing facilities, inpatient rehabilitation as well as other third-party medical billing requirements. Assigns code based on medical record documentation and seeks further clarification from physicians when documentation is unclear, illegible, or conflicting. Achieves and maintains a high level of accuracy and productivity in coded claims. Maintains a working knowledge of coding compliance. Works in conjunction with the Business Office to reconcile denied claims due to coding issues. Maintains a working knowledge of 3M system. Maintain close relationships with Providers and provide education as necessary. May perform coding audits for quality checks. Performs other related duties as assigned. Certified Coding Specialist (CCS) approved by the American Health Information Management Association (AHIMA) for inpatient or hospital outpatient coding. Bachelor or Associate degree and successful completion of the examination for Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) Certified Procedural Coder- Hospital (CPC-H) approved by AAPC for hospital outpatient coding.

Certified Coding Specialist- Physician (CCS-P) approved by AHIMA for physician services coding. Certified Procedural Coder (CPC) approved by the American Academy of Professional Coders (AAPC) for physician services coding. Certified Coding Associate (CCA) approved by the American Health Information Management Association (AHIMA) for professionals new to the coding field. These individuals must seek further certification as a CCS, CPC-H, CCS-P, or CPC dependent upon their coping expertise within 5 years of date of hire.