CPC Coder

Coding Specialists are responsible for assuring all claims are coded correctly and pass all internal edits in a timely fashion. All denied claims with coding errors are reviewed, corrected, or appealed to ensure maximum reimbursement. Coding Specialists review collector requests for claim changes and ensure all coding rules are applied correctly. 

• Ensuring appropriate information is submitted to insurance companies in order to expedite payment.

• Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal.

• Works in their assigned queues daily both pre-submission and after denial, and accomplishing the set goal totals for the individual queues weekly.

• Request appropriate adjustments based on contract, modifiers or appeal denials.

• Works to understand the procedures billed in OP notes to maximize appeals written or bundling issues.

• Utilizes the coding resources (CPT, ICD-9, CDR, AAOS books) to understand procedures that are denied.

• Corrects accounts that are billed to incorrect insurance companies.

• All other duties as assigned.