Review system-generated coding edits (e.g., CCI, LCD/NCD, MUE, medical necessity, modifier edits) and determine appropriate corrective actions.

• Analyze documentation to validate ICD-10-CM, CPT, and HCPCS assignments and ensure compliance with official coding guidelines.
• Collaborate with coding staff to resolve complex edit issues and escalate patterns or system-related problems as needed. Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms CPT codes. Inputs and maintains data on procedures required for state or other reporting. May require an associate degree. Requires a certification from AAPC Certified Professional Coder (CPC) or AHIMA RHIT or CCS. Works with the coding manager and team on this site. Has attained full proficiency in multiple specialties of discipline. Typically requires 4+ years of related OBS/OPS coding experience, and may include additional credentials. Performs coding on multiple specialties with proficiency.