The Professional Fee Abstractor will provide research for the department responding to questions regarding the assignment of correct codes. This position will also be responsible for the coding of complicated medical documentation and procedures which requires clinical knowledge and education. The coding process will use physician notes and the researched data to properly assign codes to all services performed utilizing appropriate ICD-10 CM, CPT, HCPCS codes and modifiers. Participation in coding training and education is also required as well as maintaining yearly certification as a Certified Professional Coder. Specialty certification in Orthopedic Surgery is preferred.
Additional miscellaneous duties and responsibilities, as may be assigned from time to time by employee's supervisor.
Code complex procedures and notes which require a high level of clinical and coding knowledge using appropriate procedure and diagnosis codes.
Research coding queries using approved clinical and coding sources and provide detailed education and information to staff.
Communicate timely with physicians orally or in writing regarding any documentation questions and/or coding changes and respond to physician inquiries that concern the proper documentation of diagnostic and procedural information.
Ensure that charges for all applicable patient encounters of the Nemours Children's Clinical Practice are coded in a timely manner. EPIC Work queues, daily reports and physician lists will be used to gather all information needed for coding physician services. Coding of inpatient encounters will be completed within 7 business days of submission to work queue.
Maintain a 95% accuracy rating based on Quality Reviews performed annually.
Maintain thorough knowledge and understanding of coding through Specialty specific seminars/webinars and Compliance updates. A strong knowledge of clinical practices of assigned areas is needed.
Translate diagnostic and procedural documentation into the appropriate ICD-10 CM, CPT, HCPCS codes through use of computerized systems and current coding tools.
Meet with management and Coding Integrity on a regular basis to review any new coding or documentation guidelines.
Act as subject matter expert in areas of subspecialty certification.
Escalate coding concerns or issues to departmental coding managers.
Adhere to Nemours Standards of Behavior.
One of the following: CCS-P, CPC, RHIA, OR RHIT Required