Hartsville, South Carolina
Bridgewater, New Jersey
Carmel, Indiana
Saint Louis, Missouri
Georgia
Marshfield, Wisconsin
Springfield, Missouri
Springfield, Missouri
3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and outpatient cases. Reviews coding insurance denials and refers clinical coding denials to the CDI Physician Advisors.
4. Resolves insurance denials that have been accepted by updating the coding and send for rebilling if required.
5. Generate coding appeals for insurance denials with sound arguments and based on coding guidelines and conventions.
6. Generates coding appeals as a result of CDI Physician Advisor reviews suggesting appeal. Coordinates Peer to Peer requests with third party payers and CDI Physician Advisors and prepares for meeting.
7. Researches and resolves problems referred by coders and provides prompt feedback.
8. Provides input on performance of coders and audit information to supervisor for performance evaluations.
9. Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
10. Provides training and serves as a general resource to assist other coders and members of department staff.