Codes and abstracts documents such as patient charts and pathology reports utilizing diagnostic codes. Enters data into computer system(s).

Essential Duties:

• Abstracts and assigns accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic).
• Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes.
• Provides completed patient data to billing staff or designated personnel.
• Answer incoming calls from billers, front desk staff and clinical staff as needed assisting in what may be necessary to satisfactory resolution of the issues.
• Review and resolve insurance denials by examining the provider documentation.
• Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate review of ICD10 and/or CPT code assignments with physician.
• Performs other duties as assigned.

Required Qualifications:

• Req High school or equivalent
• Req Specialized/technical training; Combined experience/education as substitute for minimum education Graduation from a formal coder training program or completion of academic class in medical coding
• Combined experience/education as substitute for minimum education
• Req 2 years; Combined education/experience as substitute for minimum experience 2 years' coding experience.
• Req Experience in using a computerized coding & abstracting software and an encoding/code-finder database systems.
• Req Demonstrates excellent verbal and written communication skills.
• Req Organization/time management skills.
• Req Able to function independently and as a member of a team.
• Req Demonstrate excellent customer service behavior.

Preferred Qualifications:

Required Licenses/Certifications:

• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
• Req Certified Professional Coder - CPC (AAPC) OR AHIMA Certified Coding Specialist-Physician (CCS-P); *Certified Coding Specialist (CCS) in lieu of (CCS-P) acceptable for employees hired prior to April 30, 2020.