QA Coder

Job Responsibilities

Review clinical documentation to ensure that diagnoses, procedures, and services are accurately coded in accordance with ICD-10, CPT, and other relevant coding standards. Verify that coding aligns with the documentation and is compliant with Medicare, Medicaid, and other insurance guidelines for home health services. Collaborate with clinical staff to resolve any discrepancies in documentation and ensure accurate coding for optimal reimbursement.

Perform routine audits of coded records to ensure compliance with internal policies and external regulations. Assist in developing and implementing coding policies and procedures to improve accuracy and compliance. Provide coding education and feedback to clinical staff to ensure correct documentation practices and adherence to coding guidelines.

Track and report coding trends, errors, and areas for improvement to the QA Manager or Billing Department. Ensure that all coded records maintain compliance with HIPAA and other privacy and security regulations. Assist with preparation for external audits by regulatory agencies or accrediting bodies, providing necessary coding documentation and reports.

Stay updated with changes in coding regulations and guidelines to ensure that the agency remains compliant with industry standards. Ensure compliance with the organization's Code of Conduct and all applicable laws, including HIPAA regulations for the protection of sensitive information. Perform any additional duties as assigned to meet the needs of the department and organization.

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