SUMMARY STATEMENT: Various duties including but not limited to: Ability to abstract Evaluation and Management Codes (both out and in-patient), Medicare Annual Exams, Observation visits, ICD-10 Diagnosis, Preventative visits; and other assignments as directed by supervisor. |
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TYPE OF SUPERVISION RECEIVED: Reports to Supervisor for FPG/PBO WQ CPC Team, however primarily operates independently, without immediate supervision. Receives additional supervision from the Coding department leadership and Director. Daily productivity and quality will be monitored. |
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Amount of Time | Duties and Tasks | Rating | Comments | |||||
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40% 40% varies varies varies varies varies |
A. Reviews Medical Records Reads and analyzes physicians notes to assess them for documentation accuracy. This involves comparing physician documentation to established Evaluation and Management Guidelines to certify the appropriate category of billing and the correct level of billing within that category. Additionally, the dates of service, CPT codes, place of service and diagnostic codes billed must be corroborated in the medical record. This assessment is required for several job functions: -Medicare audits -The University Professional Compliance Office annual assessment -Internal Audits -Physician requests for documentation review -Clarification of inpatient billing card discrepancies -EPIC experience B. Work Queue Edits: -Work assigned WQ Edits -Verifies all information supplied -Provides appropriate feedback for root cause/action items C. Corresponds with physicians regarding billing issues as needed via phone, email, etc D. Maintains Production Standards and Turn Around Time. Targets consist of a variety of E/M and procedural coding. E. Maintains Quality Standards: Quality Reviews of 95% or better. Meets production standards while maintaining quality, accuracy, and neatness F. Reviews new policy and procedures, standards and guidelines pertaining to coding to ensure an up-to-date knowledge and experience level. . G. Reads publications and attends seminars to remain current on correct coding and billing procedures. H. Provides a resource for co-workers in other areas on inpatient and outpatient charge document review, and on coding. I. Performs special assignments including entering charges, corresponding with physicians, requesting MD reports, and anything pertaining to the completion of the patient encounter. J. Performs other duties as assigned by Department Supervisor, Manager, or Director |
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UCLA C-I-CARE/Patient Experience Practices: MY COMMITMENT TO CARE
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INSTITUTIONAL AND/OR PROFESSIONAL STANDARDS
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PERFORMANCE IMPROVEMENT
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