Sr. Executive/ Executive HIM ED Profee & Facility

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• Minimum 1 year of Medical Coding Experience.
• Strong Knowledge on coding appropriate ICD’s, CPT’s and HCPC Codes.
• Strong Knowledge to ensure in assign codes based on coding and customer guidelines.
• Hands – on Knowledge in CCI edits, LCD, NCD coverage determination etc.
• Strong Knowledge in Medical terminology, Human Anatomy and Physiology
• Knowledge of coding all CPT’s related to Simple Procedures - Both Pro/ Fac
  • Laceration repair
  • Incision and Drainage
  • Foreign body removal
  • Splint
  • Fracture reduction
  • Nail Procedures
  • Epistaxis
  • Cerumen Impaction removal
  • Moderate Sedation Procedure
  • Blood Transfusion
  • Foley/ Straight Cath Placement
  • Bladder Scan
  • Fracture Care
  • Intraosseous Line Placement
  • TPA for Stroke
  • PICC Lines
  • Colposcopy
  • Burn care
• Critical care guidelines for both Professional/Facility, Carve out time guidelines.

Critical Care drugs/ Procedures – Both Pro/ Fac

• CPR
• Intubation
• Central Line Placement
• Cardioversion
• Chest tube insertion
• Thoracotomy
• Tracheostomy Insertion
• Pacemaker Insertion

ED Facility - Infusions + Injections:

• Hierarchy of injection, infusion, and Hydration guidelines
• Vaccination coding
• Drugs given for procedures like CPR, intubation cannot be captured separately
• Hydrations will be captured at any rate unless documented as TKO or KVO. Do not capture if listed as TKO or KVO
• Hydration given at the same time as a blood transfusion/ Infusion of any drug- The hydration charge will not be captured unless the documentation supports the administration of the hydration was in a different site.
• Dx to cover medical necessity of hydration
• Modifiers.
• Sound Knowledge on modifiers (XU, 52,53, 76, 77….)
• Location specific modifiers
• Strong in level of service determination with 1995 & 1997 documentation guidelines and should have proficiency in ED Profee/ Facility ACEP point calculation.
• Strong knowledge in Observation service coding
• Maintaining a quality threshold of 97% and meeting the client expectations.
• Maintaining 100% production from day 1 (per ramp)

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.