Sunday, January 30, 2022

Doctor Coding Appeals Specification

Position Requirements:

Education Required:

Advanced training beyond High School that consists of the conclusion of a certified or authorized program in Medical Coding Specialist.

Experience Required:

Typically needs 2 years of experience in expert coding that consists of experiences in doctor income cycle procedures, health details workflows and repayment in a big, intricate center or medical group.

Knowledge, Skills and Abilities Required:

Intermediate understanding of ICD, CPT and HCPCS coding standards.

Intermediate understanding of medical terms, anatomy and physiology.

Intermediate understanding of care shipment documents systems and associated medical record files.

Advanced understanding of Medicare, Medicaid and business payer coding standards.

Intermediate computer system abilities consisting of making use of Microsoft Office, e-mail and direct exposure or experience with electronic coding systems or applications.

Proficient social and interaction (oral and composed) abilities, consisting of the capability to successfully work together with several departments.

Intermediate company and prioritization skills capability to handle numerous concerns in a difficult, quick ~ paced workplace.

Intermediate analytical abilities, with an excellent attention to information.

Ability to work separately and workout independent judgment and choice making.

Ability to satisfy due dates while operating in a quick ~ paced environment.

Licensure, Registration and/or Certification Required:

Coding Associate (CCA) accreditation provided by the American Health Information Management Association (AHIMA), or

Coding Specialist ~ Physician (CCS ~ P) accreditation released by the American Health Information Management Association (AHIMA), or

Health Information Administrator (RHIA) registration provided by the American Health Information Management Association (AHIMA), or

Health Information Technician (RHIT) registration provided by the American Health Information Management Association (AHIMA), or

Professional Coder (CPC) accreditation provided by the American Academy of Professional Coders (AAPC), or

Specialty Coding Professional (SCP) accreditation released by the Board of Medical Specialty Coding and Compliance (BMSC).

Physical Requirements and Working Conditions:

Exposed to regular workplace environment.

Position needs travel which will lead to direct exposure to roadway and weather condition risks.

Operates all devices essential to carry out the task.

This task description shows the basic nature and level of work anticipated of the incumbent. It is not created to cover or consist of an extensive listing of activities, responsibilities or duties needed of the incumbent. Incumbent might be needed to carry out other associated tasks.

Purpose:

Consistent and prompt processing of coding rejection/denial appeals and client issues associated with coding, consisting of tracking for patterns and patterns, and making sure suitable repayment within regulative requirements. Interacts patterns, outcomes and barriers to the management group.

Accountabilities:

Identifies and evaluates expert coding problems, rejections and appeals for a particular population of charges. Operating in partnership with production coders.

Coordinates coding rejection information collection activities utilized for reporting and responsibility tracking. Recognizes prospective patterns or understanding issues and chances for enhancement and avoidance.

Researches and records relevant regulative, coding and billing guidelines and supplies education products for the department teachers and coding intermediaries. Establishes standardized procedures, letters and systems for the coding production group to use when handling insurance coverage rejections.

Works with profits cycle management, cli.

Aurora Health Care.

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http://medicalbillingcertificationprograms.org/doctor-coding-appeals-specification-3/

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