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CODING SPECIALIST, MIT Medical, to evaluate medical record documentation and coding to ensure that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits and that data complies with legal standards and guidelines. Will provide technical guidance to clinical providers and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines; interpret a wide variety of clinical and diagnostic documentation, including complex medical cases and treatments to identify diagnoses, complications, comorbidities, and procedures associated with outpatient visits; assign current set of diagnosis, CPT, HCPC, and modifier codes as appropriate, adhering to official coding guidelines; review all medical necessity denials received from payers and review medical records to determine if resubmission is appropriate; educate clinical staff on coding, documentation issues, and federal regulatory guidelines and compliance; prepare slides or documents for use in coding and clinical training documentation; and serve as an independent resource for CMS compliance changes and CC, NCD and LCD regulations.
Job Requirements REQUIRED: high school diploma or its equivalent; current coding certification, either CPC, RMC, CCS, CCS-P, and/or RHIT; at least three years of coding experience; ability to read and interpret medical procedures and terminology. PREFERRED: a college degree and Cerner application knowledge (comparable EMR/practice management system knowledge acceptable). Job #22105-5
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