• Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types • The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided • When applicable, apply the appropriate charges such as the Evaluation & Management (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third-party software systems such as LYNX • Correctly abstract required data per facility specifications • Perform 'medical necessity checks' for Medicare and other payers as required per payment guidelines • Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensure timely, compliant processing of outpatient claims in the billing system • Responsible to maintain established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards • Remain abreast of current requirements of the Centers for Medicare & Medicaid Services (CMS) to include National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through • Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding (CAC) Medical Necessity software, abstracting system, code books, and all reference materials • Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy • Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth