Tennessee Orthopaedic Alliance

  • Coding Coordinator

    Job Locations US-TN-Nashville
    Posted Date 3 weeks ago(4/2/2018 9:56 AM)
    Job ID
    2018-1239
    # of Openings
    1
    Category
    Central Business Office
  • Overview

    The Coding Coordinator combines clinical, business and regulatory knowledge and skill to reduce finical risk and exposure caused by inaccurate denial of payment for services provided. This individual will help support the coding team in the day-to-day operations in the coding department. This position reports to the Coding Manager.

    Responsibilities

    Responsibilities for the Coding Coordinator specifically include:

    • Initiate appropriate clinical documentation querying in order to acquire or clarify necessary medical record documentation needed to facilitate accurate and complete coding & abstracting.
    • Assess day-to-day operations and make necessary workflow adjustments to meet department specified turnaround times
    • Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services requested. Prepare reviews for cases that did not meet criteria.
    • Monitor appeal levels and workload volume.
    • Maintain an in-depth knowledge of Medicare and coding regulations and ensures that coding staff is informed and compliant
    • Maintain dialogue with payers about disputed claims and maintains documentation of ongoing efforts for each disputed claim.
    • Interface with physicians, Patient Financial Services, Patient Access and Medical Records to obtain necessary information as needed to respond to denials.

    Qualifications

    The ideal candidate will have extensive successful experience and ability to work in a fast-paced environment, with a great tolerance for shifting priorities and workflow

     

    • Proven ability to compose coding appeals based on documentation, coding guideline and Coding Clinic for coding denials and/or adjustments
    • Demonstrated problem solving skills, the ability to work independently, and the ability to perform under pressure in a positive, teamwork manner with diplomacy and tact.
    • Excellent interpersonal verbal and written communication skills to accurately relay information to staff and to internal and external customers.
    • Proficient in denial appeals process, including measuring denial and appeal activity, monitoring for patterns and trends, and reporting the outcomes of these activities as requested.
    • Experience in ICD-10 CM/PCS and CPT/HCPCS coding of Same Day Surgery/Outpatient Ancillary/ED medical records in hospital and/or outpatient clinic.
    • Extensive knowledge of coding, sequencing, and documentation guidelines.
    • Strong quantitative and analytical skills

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