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Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred.
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Under the direction of the Hospital Coding Manager or Supervisor, and exercising independent judgment within the scope of the job, the Hospital Inpatient Coder II assigns applicable ICD-10 Codes, Present on Admission (POA), Hospital Acquired Condition (HAC), and Patient Safety Indicators (PSI) using current industry standards, the Official Coding Guidelines, Coding Clinic, UHDDS and regulatory requirements.
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Thorough working knowledge of ICD-10 and CPT coding. Comprised of Tufts Medical Center, Lowell General Hospital, MelroseWakefield Hospital, Lawrence Memorial Hospital of Medford, Care at Home - an expansive home care network, and large integrated physician network.
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This position is responsible for ICD-10 Coding and OASIS Review, quality assurance, accuracy and overall integrity of the clinical records and documentation completed by Clinical staff. OASIS Certification and ICD-10 Coding Certification, preferred.
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KEYWORDS: RMF, Risk Management Framework, ICD, Information Assurance, IA, IAO, IAT, IAM, A&A, A+, Network+, Security+, Non-classified Internet Protocol Router Network (NIPRNet), Secret Internet Protocol Router Network (SIPRNet), DISA Security Technical Implementation Guides (STIGs), CISSP, CASP.
Full-timeExpandApply NowActive JobUpdated 27 days ago - UpvoteDownvoteShare Job
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Knowledge of medical coding ontologies and data models for real-world data types in US and globally (ICD, ATC, LOINC, SNOMED, CPT, HCPCS, etc). Knowledge of medical coding ontologies and data models for real-world data types in US and globally (ICD, ATC, LOINC, SNOMED, CPT, HCPCS, etc.
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Duties include hands-on coding, documentation review, coding dictionary updates, rejections and denials, surgical coding, physician or other care provider education, and other coding needs for ICD-9, ICD-10 and CPT coding of inpatient and outpatient professional charges.
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Knowledge on health care knowledge management systems (e.g. ICD, SNOMED, MedDRA, UMLS) preferred. Knowledge on health care knowledge management systems (e.g. ICD, SNOMED, MedDRA, UMLS) preferred.
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Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Advanced Proficiency in ICD-10, CPT, HCPCS, and modifiers for coding of professional fee services.
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Advise customer on Risk Management Framework (RMF) assessment and authorization issues. Prior performance in roles such as ISSO or ISSM. Develop and oversee operational information systems security implementation policy and guidelines of network security, based upon the Risk Management Framework (RMF) with emphasize on Joint Special Access Program Implementation Guide (JSIG) authorization process.
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Enters charges and reviews patient record for billing accuracy performing quality checks on ICD-10 and CPT codes and other related information in order to streamline the billing process per practice protocols.
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CPC - Certified Professional Coder (AAPC) High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.
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Thorough knowledge of ICD-10, CPT, HCPS, and Revenue Billing Codes. The Sr. Claims Auditor utilizes CPT and ICD-10 coding to review physician claims and medical records for coding accuracy.
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Experience with medical coding systems (e.g., NDC, ICD-9, HCPCS/CPT, SNOMED CT, LOINC), basic medical terminology, and epidemiologic principles a must. Experience with medical coding systems (e.g., NDC, ICD-9, HCPCS/CPT, SNOMED CT, LOINC), basic medical terminology, and epidemiologic principles a must.
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Knowledge of the correct usage of CPT, ICD-10 codes, and accurate coding of charges. Exclusive Orthopedic and Sports Medicine Partner of the RIIL collaborating through injury preventions, strength and conditioning and injury rehabilitation.
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aapc icd jobs in Woburn, MA
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