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APR Consulting · 1 hour ago

Patient Records Abstractor IV

Sacramento, CA

Contract

Onsite

Mid Level

$65.83/hr - $65.83/hr

APR Consulting, Inc. is engaged to identify a Patient Records Abstractor IV. The incumbent will perform abstracting of medical services, ensuring accuracy in coding for billing purposes and compliance with regulations.

ConsultingCRMHuman ResourcesInformation TechnologySmall and Medium BusinessesStaffing Agency

Responsibilities

Analyze Records and Documents to Determine Nature of Professional Services Rendered

Read and interpret Electronic Medical Record (EMR) documentation to determine precise nature of professional and/or facility services rendered.Read and interpret outside documentation provided by UCDHS faculty to determine precise nature of professional services rendered.Investigate discrepancies in documentation and initiate correspondence with faculty physicians for clarification.Ensure Documentation adheres to federal, state, county, and departmental guidelines.Distinguish surgical procedures, ancillary services, and evaluation and management care performed by faculty physicians from that performed by residents, interns and others.Distinguish between billable and non-billable services.Utilize Epic system to record physician feedback, physician action required, pending and non-billable services.Utilize 3M, Epic PB Charge Entry, Unit Charge, or PB Charge Review for charge capture.Utilize system reports to verify all charges entered posted in the billing system

Assign Appropriate CPT, EM, Diagnosis, HCPCS and Modifiers

Utilize International Classification of Diseases (ICD10-CM), Current Procedural Terminology (CPT-4) codes to code professional services.Analyze entire EMR documentation to distinguish slight but important categorical distinction between codes and services provided.Modify codes using CPT or payor specific modifiers to detail specific information or situations that will provide additional information or affect reimbursement

Provide visit level detail to faculty physician based on discrepancies or deficiencies noted in physician documentation.Record informational only feedback provided in the 3M system/Epic system or other described system.Record physician action required feedback provided in the 3M/Epic system or other described system.Record non-billable services provided detail in the 3M system

Perform other duties as assigned

Qualification

AHIMA CCS-P CertificationAAPC CPC CertificationCPT-4 CodingICD-10 CodingEMR Documentation AnalysisSurgical Pathology KnowledgePain Management CodingCommunication SkillsProblem Solving SkillsOrganizational Skills

Required

American Health Information Management Association (AHIMA) Certified Coding Specialist-Physician-based (CCS-P) or Certified Coding Specialist (CSS), or American Association of Professional Coders (AAPC) Certified Professional Coder (CPC) Certification

AHIMA CCS-P or AAPC CPC Certification Required

Comprehensive knowledge of medical diagnostic and procedure terminology

Knowledge of disease processes, anatomy and physiology necessary for assigning accurate codes

Ability to follow ICD-10 and CPT guidelines in assigning codes to visits and procedures

Ability to follow CMS and UCDH teaching physician guidelines in applying evaluation and management codes

Knowledge of Federal, State and local government regulations and requirements, which pertain to patient care information

Knowledge of third-party payor reimbursement requirements and reimbursement methodologies

Ability to interpret and communicate professional fee coding information to physicians and other UCDH staff

Ability to manage time schedules, deadlines, multiple requests, priorities and maintain productivity

Excellent written and oral communication skills

Problem solving and decision-making skills to independently define a problem, identify the resources available, create viable solutions and to take the necessary action

Organizational skills to maintain work area and in progress/pending work/patient lists, in such a way that the information is easily retrievable

Abides by the American Health Information Managements Association's established code of ethical principles to safeguard the public and contribute within the scope of the profession to quality and efficiency in health care, thus promoting ethical conduct

Abides by all compliance principles regarding fraud and abuse in the reimbursement environment

Employment is contingent upon successful completion of background check(s), including but not limited to criminal record history background check(s)

Employment is contingent on compliance with applicable policies, procedures and training requirements

Company

APR Consulting

APR Consulting is a nationally recognized, award-winning provider of talent acquisition and workforce solutions, helping organizations simplify, scale, and optimize their operations.

Founded in 1980