Surgical Review Specialist, Full-time(Remote)
About the position Responsibilities • Prospectively reviews, validates, and audits OR procedure code assignments for HIM, OR, and/or general surgery cases according to AMA CPT-4 coding conventions. • Identifies potential patient class mismatches based on planned OR Surgical CPT-4 assignment for all scheduled OR cases. • Ensures that appropriate IP patient class is obtained for IP-only Medicare cases prior to the date of service. • Conducts reviews of cases lost with feedback to respective departments. • Conducts concurrent review with the utilization review department for post-op surgical cases with potential status issues, procedure changes, or entry of incorrect patient class orders. • Audits CPT-4 codes provided by coders to ensure accuracy and correct patient class obtained prior to discharge. • Assists with outstanding HIM Waiting for Information queues researching outstanding inpatient and/or outpatient accounts for resolution. • Serves as a liaison between Physician Advisor/Medical Director, Finance, Utilization Review Department, and CDCI. Requirements • RHIA, RHIT, CCS and/or CPC strongly preferred. • Minimum 1-3 years demonstrated outpatient coding experience in an acute care, teaching setting; knowledge of inpatient coding preferred. • Working knowledge of CPT-4 required; ICD-10-CM preferred. • Knowledge of anatomy and physiology, pathophysiology, and medical terminology required. • Previous experience with EPIC patient medical record system and 3M encoding system preferred. Nice-to-haves • RHIA, RHIT, CCS and/or CPC-eligible or candidate currently enrolled in health information technology/management program or other health-related field. • Candidates not holding credentials are expected to obtain their AHIMA/AAPC credential within three years of hire date. Apply tot his job