Coder Edit Analsyt Performs daily coding reviews on claims as assigned, to validate the ICD-10, CPT, HCPCS codes and modifier assignments. Develops reports, collects and prepares data for process improvement, and financial impact of systemic billing and coding errors. Compares UB04 data to medical record documentation to ensure compliance with Medicare and other insurance reporting requirements. bility to identify coding and billing problems as they pertain to pre-bill and claims records review. Develop process improvement initiatives from which problems can be resolved. Must understand CMS memos and transmittals. Understand medical records, hospital bills, and the chargemaster. Understand ancillary department functions. bility to communicate orally and in written form. Perform professional and hospital related charge reviews for appropriateness of coding and charging, including business office activities, systems function and charging methodologies. Identifies patterns, trends, and variations in assigned professional and hospital claims, and evaluates the causes of identified problems. Takes appropriate steps in collaboration with the right department to effect resolution or explanation of the variance. Demonstrates ability to effectively manage multiple projects with innovation, creativity and vision. Documents results of all special projects and provides recommendations for revenue managing opportunities. Illustrates creative problem-solving skills through documentation of process improvement reporting and/or internal reporting mechanisms.