This position is responsible for reviewing and validating changes for current and upcoming LCD, NCD for medical necessity for reimbursement, for outpatient and inpatient charges. Works closely with HIM Coding Education and Management team.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
· Complies with all policies and procedures.
· Reviews, analyzes, updates and trains staff on coding changes, including LCD and NCD (local coverage determinations and national coverage determinations).
· Responsible for communicating with staff and providers across the organization.
· Consistently and accurately reviews payer updates and changes regarding coding of ICD-10 and CPT.
· Assists department with conducting trend analyses to identify patterns, variations in coding and documentation practices including areas of risk and comparing coding profiles with national and regional norms.
· Demonstrates up-to-date knowledge of healthcare regulatory billing issues, coding mandates, and reimbursement rules and guidelines.
· Produces documents of the highest professional quality: clear, concise and error free; prepared with correct medical terminology and correct use of the English language.
· Performs other duties as assigned.