Processes various claim adjustments within established timeframes, using the FACETS system and established policies. Researches claims to ensure proper adjudication and provides guidance to peer groups. Partners with other departments and vendors to complete claim adjudication.

Abstract billing for outpatient evaluation and management codes, minor surgical procedure(s) and HCPCS codes from provider documentation, assigning CPT-4, ICD-10-CM codes and modifiers, researching coding/billing issues, and analyzing medical records to determine coding appropriateness.