Medical Coder

Job Duties & Responsibilities

• Assigns ICD-10-CM, ICD-10-PCS, and/or CPT codes.
• Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.
• Communicates with and provides feedback to the education team and/or providers.
• Reviews patient charges to determine necessary coding to complete the account.
• Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.
• Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
• Sequences diagnosis and procedures to generate appropriate billing.
• Queries physicians to obtain diagnosis if not clearly provided in records.
• Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, and coding reference materials).
• Assists other coders in resolving coding problems.
• Provides ICD-10 and CPT, for physician research projects, and for quality reporting purposes.
• Assists in correction of problem accounts.
• Reviews charts for completeness
• Participates in education and maintains certification.
• Assists in auditing records.
• Communicates effectively and demonstrates good interpersonal and professional skills when interacting with others.
• Resolves claim and billing edits as well as denials by performing second review of medical record documentation and code assignments.
• Review and provide resolution of edits/warnings.
• Applies guidelines as indicated through the Local Coverage Determination (LCD), National Coverage Determination (NCD), as well as the National Correct Coding Initiative (CCI).
• Coder meets and maintains a production rate of 90% or higher.
• Coder meets and maintains an accuracy rate of 90% on all coded records.
• Other duties as assigned

• Required H.S. Diploma or equivalent
• Required 2 years coding experience with preferred experience using an encoder and experience using an electronic medical record
• Required Licenses/Certifications (one of below):
• CCA - Certified Coding Associate by the American Academy of Professional Coders (AAPC)
• CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)
• CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)
• CIPC - Certified Inpatient Coder by the American Academy of Professional Coders (AAPC)
• COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)
• CPC - Cert-Cert Professional Coder by the by the American Academy of Professional Coders (AAPC)