Sr. Executive/ Executive HIM ED Profee & Facility

• 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.

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

• 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)