PB Coder I
Grady Memorial Hospital
Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary Responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of discrepancies/trends, resolving edits and denials, and releasing encounters for billing. Utilizes intermediate problem‑solving skills to address coding related tasks of detailed, medium complexity. Duties include procedural (CPT) and diagnosis (ICD-10) coding for all places of service, including, but not limited to ER, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services. Responsible for reviewing, analyzing, and interpreting physician documentation, CPT and diagnosis coding, charge entry, coding claim edit, and coding denial management for coding related tasks. Responsibilities
- Review Clinical Documentation: Review physician or provider documentation to identify services rendered.
- Assign Appropriate Medical Codes: Apply correct CPT , ICD10CM , and HCPCS codes for: E/M services, Diagnostic and procedural services, Facility or professional fees.
- Ensure Compliance: Validate that documentation supports billed services; ensure coding follows Medicare/Medicaid regulations, CMS guidelines, and CPT documentation standards.
- Resolve Coding Edits & Denials: Navigate EMR work queues (e.g., Epic) to address claim edits and charge review items; resolve coding–related denials to support accurate reimbursement.
- Maintain Productivity & Quality Standards: Meet hourly productivity and accuracy standards set by enterprise coding teams.
- Conduct Quality Audits: Perform audits within specialty areas to ensure coding accuracy and identify improvement opportunities.
- Provide Education & Feedback: Educate providers on documentation and billing requirements; communicate trends in coding errors and denials.
- Collaborate Across Teams: Work with billing departments, coding leadership, and clinicians to resolve billing or documentation concerns.
- Enter and Validate Billing Data: Perform accurate charge entry and ensure all billing information is complete.
- Develop Process Documentation: Create workflows, tip sheets, and written procedures to improve coding processes and train peers.
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