1. Handle incoming and outgoing calls/e-mails to and from Physicians, department administrative assistants, the billing office, compliance office and others
2. Mail, fax, and handle correspondence.

1. Care and maintain office equipment
2. Develop and maintain mailing lists and tickler file
3. Inventory Management
4. Use Query database to retrieve information

1. Use and understand format, conventions, guidelines and rules of ICD-10-CM diagnostic and procedural coding
2. Coding of insurance forms using ICD-10-CM and CPT
3. Process and complete all insurance forms
4. Code diagnoses and procedures

1. Retrieving and filing of medical records; keep medical records updated; locate data in and abstract information from medical records

1. Comply with regulations related to fraud and abuse
2. Compare non-government payers versus government payers
3. Compare other prospective payment systems
4. Understand and comprehend reimbursement cycle
5. Apply facility based codes (i.e., Diagnostic Related Groups, Ambulatory Payment Classifications, and Resource Utilization Groups)

1. Investigate health plan payment denials and write claims appeal
2. Understand and follow claim rejection and resolution process
3. Use coded data in strategic planning/reporting
4. Perform qualitative and quantitative analysis of health records to evaluate compliance with regulations and standards
5. Research coding updates
6. Examine review systems

1. Audits indicate accuracy of diagnostic and procedural coding

1. Demonstrates understanding of clinical vocabularies

1. Audits indicate compliance with abstracting policies

1. Audits indicate appropriate code and sequencing following regulations and guidelines

1. Audits indicate accuracy of MSDRG/APC assignment

1. Audits indicate appropriate code sequencing

1. Follows coding edits for compliance with NCCI

1. Audits indicate appropriate code and sequencing following regulations and guidelines

1. Audits indicate appropriate use of LCD and NCD in coding

1. Compliant with claim submission and claim denials policy

1. Meets timeliness and accuracy of record analysis

1. Follows policy on information and data collection

1. Creates compliant physician queries

Program Overview

This course covers medical terminology, symbols and abbreviations, and the application of this new language in the field of health care.  While terms are covered as they relate to body structure and function, the main focus is on medical vocabulary and being able to construct terms using word parts such as roots, suffixes, and prefixes.

This course provides an overview to the anatomical structures and physiology of the human body. Each body system is discussed in terms of the major anatomical structures and function including how each system participates in homeostasis of the body. In addition, the course discusses selected major pathologies, including disease definitions and causes, signs and symptoms, diagnostic procedures, and possible treatments. Finally, the course discusses common issues and changes that occur in each body system through the life span.

Emphasis is placed on the disease processes affecting the human body via an integrated approach to specific disease entities. Included will be the study of causes, diagnosis and treatment of disease as well as an understanding of the basic principles of pharmacology

An introduction to the organization, financing and delivery of health care services, this course gives an overview of the organization and activities of hospitals, nursing homes, mental health and ambulatory care centers, home health agencies, and hospices. Apprentices will also learn about the educational preparation and responsibilities of health care professionals and government regulations.

This course introduces apprentices to the contents, use and structure of the health record, including data and data sets. It explains how these components relate to primary and secondary record systems and gives an overview of the legal and ethical issues applicable to health information.

This course introduces apprentices to legal and ethical issues related to the health care setting. This course provides an overview of the laws and professional requirements that regulate the delivery of health care, including HIPAA, the Patient's Bill of Rights, and standard of care. Apprentices will also gain an understanding of the ethical and moral issues that health care professionals may encounter.

This course provides the apprentice with the basic principles of the ICD-10-CM Coding and Classification System, including the following of guidelines, proper sequencing of codes and theimpact on reimbursement.

A continuation of Part 1 of the Basic ICD Coding course, Part 2 focuses on ICD-10-PCS coding. This course emphasizes practice in the assignment of valid ICD-10-PCS procedure codes.

An introduction to basic coding concepts using CPT/HCPCS. Coding/classification systems, this course emphasizes practice in the assignment of valid diagnostic and procedure codes in an ambulatory care setting. The course covers procedural terminology in current use, evaluation and management services, medicine, HCPCS Levels II and III and CPT Category II and III Codes

A continuation of Part 1 of the Basic CPT/HCPCS Coding course, Part 2 utilizes higher level, more complex examples (case studies, records and scenarios). This course covers surgery coding, anesthesia coding, radiology coding, pathology and laboratory coding, and reimbursement in the ambulatory setting. Students are assigned exercises to complete using Nuance Healthcare's Clintegrity 360 encoder.

Emphasis is placed on the uses of coded data and health information in reimbursement and payment systems appropriate to all healthcare settings and managed care. Students are exposed to the contemporary prospective payment systems used by the U.S. government and other key health plans that comprise most patients' source of payment for healthcare services.

This course offers apprentices the ability to practice coding in real-world professional coding scenarios. Apprentices step through more than six different settings to complete 101 online coding exercises using either codebooks or the 3M Encoder. In addition, using official coding guidelines, preparing for a career, keeping code sets current, and applying standards of ethical behavior are covered.

Retired CCA exam questions.

Review activities, provide feedback and instruction.