Job Description
MicroHealth is seeking an experienced Medical Billing, Coding and Denial Specialist with CareVue (or similar EHR) experience to provide hospital medical billing and coding support services. This position will ensure accurate clinical coding and timely preparation and submission of hospital medical billing claims for both inpatient and outpatient hospital services. The specialist will operate as an extension of customer's current medical billing and coding team, working remotely based on operational needs. Incumbent will work rotating shift. Essential Duties and Responsibilities Inpatient Coding Assign accurate and compliant ICD-10-CM diagnosis codes for inpatient encounters Assign accurate and compliant ICD-10-PCS procedure codes Review physician documentation for completeness and accuracy Identify complications and comorbidities (CC/MCC) to ensure appropriate DRG assignment Query physicians for documentation clarification when necessary to support accurate coding Ensure compliance with all applicable coding guidelines including Official Guidelines for Coding and Reporting Outpatient Coding Assign accurate CPT/HCPCS codes for outpatient services Assign accurate ICD-10-CM diagnosis codes for outpatient encounters Perform APC assignment for outpatient services Code observation services in compliance with CMS guidelines Code emergency department encounters with appropriate E/M levels Code same-day surgery procedures Code outpatient diagnostic services (radiology, laboratory, cardiology, etc.) Claims Preparation and Submission Review encounter/charge data for completeness prior to claim submission Prepare UB-04/837I institutional claims and CMS-1500/837P professional claims Validate all coding assignments and charges against documentation Validate critical data elements including: Member/patient identification numbers National Provider Identifier (NPI) numbers Provider taxonomy codes Procedure modifiers Units of service Attending and operating provider information Verif
