Job Description
Essential Job Functions
• Reviews and analyzes inpatient, outpatient, and professional medical records to accurately identify principal and secondary diagnoses, procedures, and services
• Assigns appropriate ICD-CM, ICD-PCS, CPT, and HCPCS codes in accordance with official coding guidelines, payer requirements, and Billings Clinic policies
• Utilizes computerized encoding systems and approved reference materials to ensure accurate code selection, sequencing, and compliance
• Calculates and validates Diagnosis-Related Groups (DRGs) and Ambulatory Payment Classifications (APCs) to support accurate, ethical reimbursement
• Assigns Present on Admission (POA) indicators accurately for inpatient encounters
• Identifies and captures missing or incomplete charges and documentation to support appropriate billing
• Ensures coded data accuracy prior to billing interface and claims submission, including discharge disposition, modifiers, performing provider, ...