Medical Abstractionist - Physician Practice Philadelphia, PA

Medical Abstractionist - Physician Practice Philadelphia, PA

All On-site

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Job Description

This role will be responsible for reviewing medical record documentation including procedure reports and assigning appropriate CPT and ICD-10 codes. This role is also responsible for timely charge submissions and or data entry of the coded services.

Essential Functions

Systematically review and analyze patient medical records to determine all appropriate diagnosis and procedures performed, and to produce coded abstract for physician billing.

Submission of coded services for billing and or data entry of the coded services for claim submission in accordance with departmental productivity and accuracy standards.

Review of inpatient data and reconciliation of billable services including, review of system processing and appropriate escalation and timely communication of errors and omissions and clinical documentation insufficiencies.

Review and resolution of coding related edits and errors that impact claim submission.

Maintaining thorough knowledge of coding and documentation requirements outlined by CPT, ICD-10 CMS and CHOP Compliance for all physician services performed.

QUALIFICATIONS

Education

Education Level Field of Study Required/

Preferred

High School Diploma / GED Required

Associate's Degree Preferred

Work Experience

Experience Experience Details Required/

Preferred

At least one (1) year coding experience Required

At least two (2) years coding experience Preferred

Licenses, Certifications, and Registrations

Licenses/Certifications Issuing Agency Time to Obtain Required/

Preferred

Certified Professional Coder (CPC) American Academy of Professional Coders (AAPC) upon hire Required or

Certified Professional Coder Apprentice (CPC-A) American Academy of Professional Coders (AAPC) upon hire Required or

Certified Outpatient Coder (CPC-H) American Academy of Professional Coders (AAPC) upon hire Required or

Certified Coding Specialist (CCS) American Health Information Management Association (AHIMA) upon hire Required or

Certified Coding Specialist-Physician-Based (CCS-P) American Health Information Management Association (AHIMA) upon hire Required

Knowledge, Skills and Abilities

Skills Required/

Preferred

Advanced knowledge of specialty coding.

Advanced knowledge of ICD10, third party procedures, and requirements regarding benefit structures, insurance verification, referrals and authorizations.

Advanced knowledge of general financial counseling and the revenue cycle.

Familiarity with electronic health records (EHR).

Intermediate proficiency with office software (Microsoft Office) including word processing and spreadsheet software (Word, Excel)

Excellent verbal and written communications skills

Excellent interpersonal skills

Strong critical thinking / problem-solving skills

Strong analytical skills

Ability to maintain confidentiality and professionalism

Ability to work independently with minimal supervision

Ability to gather, analyze and make recommendations/decisions based on data

Ability to convey complex or technical information in an easy to understand manner

Physical Demands

A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.