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Coding Quality Specialist
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- The Coding Quality Specialist will review coded medical records for coding and DRG accuracy by verifying that the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures have been documented, assigned, and billed at the appropriate level for reimbursement to which the facility is legally entitled.
- Audit appropriate CPT-4 codes for evaluation and management services and specified procedures.
- Identify unbillable events due to insufficient documentation by the rendering or requesting physician.
- Meet production goals set by the Director of Revenue Process and Finance Team. Summarize and report quality results and coder productivity on a weekly basis and submit to management monthly.
- Respond to all third party audit findings (i.e., Viant, Quality Insights, Americhoice, IBC), as needed, for RAC activity.
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