Job Responsibilities for Specialist
- AventisRCM is a leading force in Revenue Cycle Management
- Providing expert solutions that ensure compliance
- Accelerate cash flow, and optimize financial performance for healthcare providers across the US.
- We are seeking sharp, detail-oriented medical coders to maintain our gold standard of accuracy and efficiency.
- Gather data and assess patient needs.
Key Responsibilities
- Accurate Code Assignment: Review clinical documentation (e.g., physician’s notes, operative reports, discharge summaries) and accurately assign CPT$^{\textregistered}$, ICD-10-CM, and HCPCS Level II codes for diagnoses, procedures, and services.
- Compliance & Policy Adherence: Ensure all coding practices adhere to official coding guidelines (AAPC/AHIMA), payer regulations, and federal compliance requirements (HIPAA, OIG).
- Query Management: Identify and flag documentation discrepancies or deficiencies, and communicate effectively with clinical staff and physicians via coding queries to ensure complete and accurate documentation.
- Denial Prevention: Work proactively to minimize claim denials by ensuring medical necessity and payer-specific coding requirements are met.
- System Utilization: Utilize RCM software, coding encoders, and electronic health record (EHR) systems proficiently to process and submit coded data.
- Stay Current: Maintain up-to-date knowledge of coding changes, conventions, and regulations by participating in continuous education and training.