GENERAL SUMMARY:

Under minimal supervision, in accordance with established policies, procedures, guidelines and criteria, regularly exercises clinical judgment in the review and assessment of audit related denials for outpatient, procedural, and inpatient cases. Using established coding principles and procedures reviews, analyzes and reviews diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines. 

EDUCATION/EXPERIENCE REQUIRED:

Minimum three-five (3-5) years of clinical experience preferred. Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. Minimum of two years inpatient and outpatient coding experience preferred but not required, with additional experience preferred.

CERTIFICATIONS/LICENSURES REQUIRED:

RHIT, RHIA, or related coding certification required. Additional Information Organization: Corporate Services Department: Payor Audit Shift: Day Job Union Code: Not Applicable