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Optim Health SystemCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in ICD-10 and CPT coding, ensuring compliance with payor guidelines and maintaining coding accreditation. Proficient in auditing E/M documentation and managing patient demographic information while adhering to confidentiality standards.
Highest-signal resume keywords
ICD-10 CodingCPT CodingCoding AccreditationAthena Software ProficiencyE/M Documentation Auditing
About the role
Key responsibilities & impact- Obtain hospital dictation and charge slips and code them according to payor guidelines
- Update physician coding as appropriate
- Verify and update patient demographic information; create new patient accounts when required
- Obtain demographic and authorization information from facilities
- Code and post charges accurately and timely, including comments for global periods, modifiers, pricing, and reporting fields
- Complete missing slips daily and verify surgical appointment posting
- Print daily schedules and periodically run Missing Slip Reports
- Compare pre-certified codes with documentation and notify providers and precertification staff of approved code changes
- Ensure precertification/authorization documentation is attached to claims
- Record and balance posted charges daily
- Assist departments, offices, and patients with coding and payment questions
- Post prepayments to surgery charges
- Handle Athena worklists and coding scrubs, including diagnosis, medical necessity, modifiers, assistant surgeons, and appeals
- Correct charges for other insurance carriers, including moving charges, payments, and adjustments
- Audit E/M documentation for physicians
- Prepare various reports
- Maintain coding accreditation and/or licensing and complete required annual training
- Maintain strict confidentiality and perform related duties as required
Requirements
What you’ll need- Certification/licensing in the chosen coding field must be maintained
- Maintain yearly Healthstream courses
- Current knowledge of ICD-10 and CPT coding
- Familiarity with payor guidelines, coding rules, modifiers, pricing, medical necessity, appeals, and insurance authorization/precertification processes
- Ability to use multiple software programs, including Athena
- Ability to verify patient demographics and authorization information
- Ability to audit E/M documentation
- Ability to maintain strict confidentiality
- Must remain current with state and federal legislative changes affecting outcomes
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding AccuracyCharge PostingModifier ApplicationPrecertification ProcessesInsurance AuthorizationMedical Necessity EvaluationReport PreparationPatient Account ManagementSurgical Appointment VerificationDaily Charge Balancing
Soft Skills
Attention to DetailConfidentiality MaintenanceCommunication SkillsProblem-Solving
Tools & Technologies
Athena
Certifications & Qualifications
Coding CertificationHealthstream Course Completion
Industry Keywords
Payor GuidelinesCoding RulesModifiersPricingAppealsInsurance AuthorizationPrecertificationE/M DocumentationLegislative ChangesPatient Demographics