The Coding Apprentice reports to the Manager of Physician Coding and Supervisor. Performs duties necessary to ensure optimal coding and data entry of the charges as well as resolve claim issues (such as diagnoses CPTs and modifiers) in the work queues. Works with front office staff when necessary and may assist in investigating and resolving denials.
Verifies payer eligibility and that pre-authorizations and referrals are in place. Enters or updates patient demographic information.
Crosswalks codes when required. Reviews accuracy of coding for procedures billed globally.
Enters all charges within two business days of date of receipt. Reviews and analyzes charge edits reports. Resolves claim edits and rejections identifies the root of the issues recommends changes to prevent future edits and corrects claims as needed.
Reconciles encounter forms to charges entered. Audits encounter form for appropriate assigned physician prior to claims submission.
Logs and date stamps incoming work received from clients and front office staff and give to Coding Manager for assignment to staff.
Performs other duties as assigned.
High school level of knowledge or equivalent.
Certification in procedural coding (preferably CPC-A).
Experience with CPT ICD-9/10 and HCPCS coding guidelines as well as reimbursement policies and procedures.
Ability to use computer applications including Invision/SMS eClinicalWorks Epic or other practice management system Excel Word Adobe Reader Microsoft Outlook and third party payer websites.
Strong organizational skills and follow-through required.
Able to meet deadlines and work well under pressure.
A normal office environment with some exposure to patients with illnesses or injuries.
Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.
Location: Corporate Headquarters USA:RI:Providence
Work Type: Full Time