Coding Lead- IP /OP
Reno, NV 89501 US
• Addresses appeals and complex medical record review needed for insurance denials to facilitate expedient resolution and reimbursement.
• Participates in mandated Medical Record Review processes.
• Interprets and applies American Hospital Association (AHA) Official Coding Guidelines to articulate and support appropriate principal, secondary diagnoses, and procedures.
• Ensures that all factors necessary for assigning accurate DRG, ICD-10 CM, ICD-10 PCS and/or CPT, HCPCS, E & M and modifiers are present, and that related diagnoses are ranked properly when applicable.
• Assign accurate present on admission indicators when applicable.
• Provides information and responds to inquiries regarding medical documentation and DRG’s, PSI’s and HAC’s to CDI staff including Utilization and Quality Assurance Departments when needed.
• Knowledge of discharge disposition and reimbursement outcomes.