Outpatient/Provider Coder III

Performs the final reconciliation on clinic or provider visits and resolves missing, incomplete, or inconsistent documentation by contacting appropriate personnel.

Reviews, abstracts, and codes multiple or sub specialty services and complex or unusual cases, and assigns appropriate coding classifications.

Interacts with and serves as a resource to coding staff, business office, providers, hospital staff, clinic managers, and other clinical personnel on billing related issues.

Researches and resolves high volume accounts, complex or escalated suspended claims, and compliance issues using appropriate databases and shares this information with other coding staff.

Researches, interprets, and applies regulatory guidelines to coding and reimbursement decisions and educates staff on associated guidelines and resolutions.

Assists in the auditing process.

Trains levels I and II coders and may serve as a project lead.

Assists with backlog to maintain department quality and productivity standards.

Assists with other department coding needs, as requested.

May participate on committees and work groups.

May formally present information to providers and assist in training efforts regarding coding and billing.