Senior Coder, Ambulatory Surgery Center
Location: Little Rock
Posted on: August 7, 2022
JOB SUMMARY: The ASC Coding and Authorization Specialist will
work collaboratively with the ASC leadership team and Finance team
to ensure proper processes are in place for the efficient and
accurate handling of prior authorizations as well as charge capture
and coding. This position will be responsible for verifying the
patient's payer coverage/non-coverage to obtain the proper prior
authorization necessary for full reimbursement for services from
the payer. The ASC Coding and Authorization specialist will also be
expected to be the expert in ASC coding procedures and guidelines
in compliance with federal, state and payer requirements and
EDUCATION, CERTIFICATION, LICENSURE, REGISTRATION: College degree
or equivalent. EXPERIENCE, KNOWLEDGE, SKILLS and ABILITIES: 1.
Minimum of six years' experience working in Oncology prior
authorization and/or coding field. 2. Minimum of two years'
experience working in an ASC environment.3. Coding Certification
from an accredited program for ASC coding (CIRCC, CCS, CPC) is
required.4. Knowledge of CPT/ICD 10-cm and HCPCS for devices and
SPECIFIC JOB DUTIES AND RESPONSIBILITES:1. Pre-Authorization
Verification a. Participates in facility specific training as
requiredb. Follows the established protocol for pre-authorization
services and provides insight for policy and procedure revisions to
stay in line with best practice standardsc. Verifies all insurance
coverage and determines patient's responsibility if applicabled.
Obtains precertification number if applicablee. Determines patient
qualification for coverage by payer and informs financial
counselor, patient, or family member of statusf. Maintains current
list of facility insurance contracts and payment schedulesg.
Documents prequalification for payer before date of scheduled
admissionh. Maintains current information on correct and lawful
practices for billing government and private payers for ambulatory
surgery carei. Follows all federal, state, and regulatory
guidelines to maintain compliancej. Enters all insurance
information into computerk. Ensures that patient financial
counselor is aware of any copayments, deductibles, etc.2. Medical
Codinga. Participates in facility specific training as requiredb.
Follows the established protocol for coding services and provides
insight for policy and procedure revisions to stay in line with
best practice standardsc. Reads and understands operative reportsd.
Assigns CPT and HCPCS procedure code for each case in a timely
mannere. Questions physicians' offices or business office
coordinator regarding any complex/unusual casesf. Understands
concept of unbundling and heeds government and payer regulationsg.
Assigns diagnosis codes to the highest level of specificityh.
Understands Medicare/payer groups rules and regulationsi.
Understands and abides by billing compliance regulationsj.
Understands anatomyk. Appends bilateral, multiple procedure, and
special requirement modifiers appropriatelyl. Completes coding
Keywords: CARTI, Little Rock , Senior Coder, Ambulatory Surgery Center, Healthcare , Little Rock, Arkansas
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