- Review and validate E/M coding for behavioral health encounters in a pre-bill workflow
- Ensure coding decisions align with documentation, payer guidance, and compliance best practices
- Define clear standards for when revenue capture is appropriate vs when risk is too high
- Develop and enforce guidelines for E/M level selection, psychotherapy add-on code usage, and documentation requirements
- Act as the escalation point for complex or ambiguous coding scenarios
- Support internal QA and calibration to maintain consistency over time
- Collaborate with Product and Engineering to operationalize coding rules
- Identify patterns in coding risk or opportunity across large datasets
Compliance