Medical care evaluation specialist vs medical coder

Differences between medical care evaluation specialist and medical coder duties and responsibilities

Medical care evaluation specialist example responsibilities.

• Apply Medicare, Medicaid billing guidelines to achieve maximum reimbursement.
• Retrieve specific records and documents for emergency room, critical care unit, medical surgery and cardiology departments.
• Coordinate with interdisciplinary team members to ensure MDS complete accurately and timely for submission and subsequent reimbursement.

Medical coder example responsibilities.

• Manage all EDI relate communication with trading partners and assist to produce all operational documents for all end users.
• Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
• Manage health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
• Manage the outsourced transcription company.
• Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
• Adhere to regulations with CPT-4, ICD-9-CM and HCPCS coding with medical terminology and effort meet all audit requirements.
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