Professional, Certified Coding Integrity

The Certified Coding Integrity Professional is responsible for all aspects of the coding and billing of all inpatient and outpatient claims, as well as all aspects of the CCM billing.

The Certified Coding Integrity Professional, a key position in the Revenue Cycle, facilitates the coding as well as manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients related to coding issues.

The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues and will have an onsite presence at the clinical locations.

While living and demonstrating our Core Values, the Certified Coding Integrity Professional will:

• Perform accurate and timely multi-specialty coding for daily claims submission.
• Prepare and submit clean claims to third-party payers working closely with clinical team members regarding claims appeal, denial, and resolution.
• Perform audits of the daily billing summary reviewing the quality of the clinical documentation and coded data to validate that the documentation supports services rendered while ensuring the integrity of the coding.
• Respond timely (either orally or written) to account inquiries from patients, third-party payers, clinical providers, and/or other staff on claims submission.