Coding Quality Specialist 2 (PB – PM&R |Musculoskeletal)

Assigns and reviews the accuracy of the diagnostic codes (ICD-10-CM) and CPT codes for providers’ Evaluation and Management Services (E/M), procedures and diagnostic testing in all settings for purposes of billing, research and providing information to government and regulatory agencies. Incumbent may perform only certain of the following responsibilities depending on their work assignment.

+ Reviews documentation in medical record to appropriately assign ICD-10-CM, CPT-4, HCPCS and modifiers within a timely manner to capture all services rendered by providers at all locations. Encounters may be within Epic, outside electronic medical record systems, or based on paper documentation.
+ Reviews and resolves charge sessions that fail charge review edits, claim edits and follow-up work queues, identifies areas of opportunity based on findings/resolution of errors.
+ Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge...

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