Wiki Job Duties

[ywilliamsCPC]

Appeals and Denials

One of the reasons I got into coding besides professional growth is because I wanted to concentrate on one thing and not constantly juggle 4 or 5 positions. I'm wondering what other responsibilities do you have besides coding.

Currently I do all the coding for our 18 docs and CRNAs, charge entry, drop claims and apply prepayments. Soon, I will start working the appeals and denials. I also back up the insurance verification and prepayment collection person.

I really don't see how I'm going to be able to work appeals and denials with my current work load. We do up to 50 cases daily sometimes more.

Just trying to get a good view of what a coders job encompasses.

 

[dwaldman]

The question is how many hours out of the week can put to appeals/denials. Can you work on it for an hour per day or take each Friday afternoon to work on it.

You can determine the amount time that you can put towards and then show the necessary people at the organization, the results of working on it for this many hours per week. If they are ok with what can be accomplished and would outweigh paying additional person to do it, then being behind is ok, if not you have presented to them and potentially re-allocated other staff or new employee to that.

The volume you are describing that you are responsible for and amount of additional tasks you are doing does seem like a lot. I guess the question is do you like doing multiple parts of the coding/billing process or do want to code procedures and/or EM only and are there positions available for that where you are located. And if is is strictly coding that you want, can you meet the type coding experience that is required for strictly coding position to meet the employers complexity of services that are provided.

 

[Pam Warren]

It depends on where you work.

Coders in facilities typically only code. Patient registration is handled by Patient Access, and billing is handled by Revenue. That having been said, however, most coders are expected to meet productivity and accuracy standards.

Coders in private practice frequently do the entire revenue cycle function: patient registration, coding, billing, accounts receivable, (payment posting, appeals), etc. Sounds like that's what you're doing, but in a practice setting, you should have one coder/biller for each 6-8 providers. Doing all that for 18 providers is going to burn you out.

Keep track of how long it takes you to do what you do today, along with a very specific list of all your duties and responsibilities. If there's any 'free time' available to you, ask your manager to help you prioritize what she/he believes is most important for you to complete. It may be that she/he has no idea what you do, and is placing unreasonable expectations. If she's not responsive to your concerns, I'd focus only on coding, charge and payment posting and big dollar appeals as the most important tasks.

 

[ywilliamsCPC]

I'm the only certified coder or coder period for that matter at my job. My employer just built an outpatient surgery center and soon I will be helping with outpatient coding, which is really what I want to do anyway but right now I'm doing physician coding only.

Currently, I enter up to 65 claims a day along with my other responsibilities and our claim denials are really low but as we bring on more docs and surgeons, I just don't think I will be able to keep up.

You have given me some great ideas that I'm going to start implementing today. I like the experience I'm getting with both physician and eventually outpatient coding. I think it will be good for me in the long run to have experience in both. I just didn't realize that I would be doing so much billing, which I do not like. I wanted to just code only. I'm okay with productivity and accuracy stipulations because I have quotas here as well.