General Summary: Under the supervision of the Coding Supervisor, the coder performs coding and billing functions required to submit clean claims to third-party payers. This position is responsible for abstracting clinical info from a variety of medical records and assigning appropriate ICD, CPT, and HCPCS codes according to established coding guidelines.
Minimum Credentials: (understanding, abilities, and capabilities)
High school diploma or equivalent
Understanding of medical terminology and human anatomy
Basic office skills consisting of proficiency in Microsoft Word, Excel and Outlook
Strong interaction abilities
Detail oriented with good issue solving abilities
Open to new knowing experiences
Preferred Certifications:
Medical coding experience (both CPT & ICD-10)
Experience with Meditech, IMPRESSIVE, Groupcast (GPMS), & PowerPath
Understanding of 3M coding software application
Essential Task Responsibilities:
Coordinates with scientific staff to make sure suitable charge details for all clients
Applies CPT codes in accordance with the CPT Handbook, NCCI Edits and other Pathologist provided information.
Uses medical diagnosis codes in accordance with CMS coding guidelines
Ability to utilize multiple websites to support code project
Capability to properly and totally code under Compliance Standards
Performance Requirements:
Coordinates with medical staff to make sure suitable charge details for all clients
Review pathology reports to confirm the suitability of CPT codes applied during accessioning
If disparities are noted, ask for coding corrections are to be sent out to the suitable stemming website
Field questions from Pathologists and other scientific personnel relating to proper coding
Verify and complete charge details in database
Coordinate with billing personnel to resolve denials based on coding concerns
Applies CPT codes in accordance with the CPT Manual, NCCI Edits and other Pathologist supplied info
A working knowledge of molecular, anatomic pathology and cytopathology CPT codes and their definitions is used to ensure each CPT code billed is appropriate for the procedure performed
A limited knowledge of scientific pathology CPT codes as utilized for the correct coding of HPV tests
Verify all CPT codes used by other Incyte and health center lab staff for appropriateness and request changes for incorrect coding when needed
Guarantee that each CPT billed is sufficiently recorded
Utilize the NCCI modifies published by CMS to identify the appropriateness of billing or the need for modifiers to clearly define the procedure performed
Follow published literature for coding changes and information
Uses diagnosis codes in accordance with CMS coding guidelines
Follow all released CMS standards for ICD-10 coding unless otherwise advised by a pathologist
Apply suitable diagnosis codes to each case designated
Examine files for accuracy and completeness
Efficiency and accuracy requirements must be preserved and will be monitored routinely via internal audits
ICD-10 error rate under 3%
CPT mistake rate under 1%
Typical cases coded per hour 55
Consult with other coding personnel and/or pathologists when a medical diagnosis is unclear
Coordinate with billing personnel to fix coding errors found by payers
Field questions from referring offices and Incyte staff relating to diagnosis coding
Ability to make use of multiple websites to support code project
Must have the ability to use the web to research study and confirm proper usage of ICD and CPT codes
Understanding of excellent resources for code verification
Usage of other companies LIS (Copath, Epic, Meditech) needed to acquire or confirm info to designate right CPT and ICD-10 codes
Capability to properly and totally code under Compliance Guidelines
Must possess knowledge of coding compliance guidelines
Must use all compliance requirements when assigning billing codes
EEO Notification
Incyte Diagnostics is an EOE, consisting of disability/vets
Incyte Diagnostics is an EEO employer – M/F/Veteran/ Disability/Sexual Orientation/Gender Identity.
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