Claims Coder

Under general supervision, performs daily activities related to analyzing medical records/chart notes/medical invoices to validate the correct coding assignment of International Classification of Disease (ICD), Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS) codes.

Principal Duties and Responsibilities:

• Perform coding work requiring independent judgment with speed and accuracy
• Examining international claims and medical records to assign ICD-10 codes for all diagnoses, treatments
• and procedures based on classification system for inpatient/outpatient encounters
• Exceptional inpatient and outpatient coding
• Exceptional knowledge of modifiers and HCPCS
• communicating clearly and concisely, orally and in writing
• Confidentiality of all HIPPA and PHI guidelines
• Ability to use the computer and basic Windows programs
• Ability to work independently to accomplish assigned work in a timely manner
• Ability to communicate with staff and the public, both in person and over the telephone, in a tactful manner and under difficult situations
• Understanding and carrying out verbal and written directions
• Follow established policies and procedures
• Works independently in the absence of supervision
• consistently meets all productivity and quality metrics
• Works under pressure and stress due to the diversity of our clients

Required / Desired Knowledge, Experiences and Skills:

• Minimum of 2 years’ experience using medical coding with CCS certification

• Experienced with standard claim form UB04/CMS-1500 and international invoices.

• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.

Education/Certifications:

• High School Diploma or Equivalent (GED) required
• Certified Professional Coder (CPC)

Physical Working Environment:

While performing the duties of this job, the employee is required to stand; walk; sit for long periods of time; use of hands to grasp, handle, or feel; reach with hands and arms; finger dexterity; talk; hear. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

The above statements are intended to describe the general nature of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties and skills required of employees so classified.

Reporting and Control

This position reports directly to the Claims Coding Supervisor. This position supports Claims functions across the following North American legal entities: GMMI, Inc.