CODER ANALYST CMG

Covenant Health; Knoxville (TN); On-site; USD 60,000 - 80,000; Full time

Job summary

Covenant Medical Group is seeking a Coder Analyst to analyze documentation and assign ICD-10-CM and CPT-4 codes. The role supports accurate coding in collaboration with providers and the Billing Department.

You will review encounters, query physicians for clarification, and participate in coding audits to maintain compliance and timely billing.

Qualifications

• One year of experience coding ICD-10-CM and CPT-4.
• Professional coding experience preferred.
• Ability to query physicians for clarification and ensure documentation supports coding.

Responsibilities

• Review medical records to determine ICD-10-CM and CPT-4 coding for billing/reimbursement.
• Verify data in the medical record and abstract pertinent information for charge entry.
• Assist provider with coding questions and refer complex issues to the Operations Manager.
• Edit unbilled claim transmission reports to ensure timely billing.
• Participate in quality coding reviews and audits for each provider.

Skills

ICD-10-CM coding

CPT-4 coding

Medical record review

Data abstraction

Job description

Overview

Coder Analyst, [Department Name]

[Type, HPPP, Shift]

Covenant Medical Group Overview:

Covenant Medical Groupis the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team deliversexpertiseacross a broad spectrum of specialtiesfrom primary careand walk-in clinics topreventive medicineandadvanced surgical andsubspecialty services.We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home.

Position Summary:

Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and enters data from the medical records in order to maintain a database for statistics and reporting. Assists the Billing Department in timely billing and rebilling of patient information.

Responsibilities

• Reviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities.
• Verifies data in the medical record and accurately abstracts pertinent information for charge entry.
• Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal procedure(s) and related diagnosis.
• Edits unbilled claim transmission reports daily and makes necessary corrections to ensure accuracy and timely billing.
• Participates in quality coding and audit reviews for each provider.
• Assists provider with coding questions for all services rendered.
• Assists other coders with coding questions to determine the most appropriate codes used for billing compliance and refers coding questions to the Operations Manager when additional research is needed.
• Contacts physicians for clarification and medical necessity.
• Reviews all encounters for accurate documentation and coding of services rendered.
• Communicates pending items and questions with office manager, CDI supervisor, and manager.
• Demonstrates ability to meet or exceed practice quality and quantity standards.
• Liaison between practice specialty and insurance company for benefit determination and claim rejections.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Qualifications

Minimum Education:

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Professional coding experience is preferred.

Minimum Experience:

One (1) year of experience assigning ICD10 and CPT codes for Physician professional services or previous completion of a recognized billing and coding course.

Licensure Requirement:

None