Full-Time Medical Coder

Duties/Responsibilities:

• Evaluates medical record documentation and charges to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately and completely reflects and supports services provided, and to ensure that data complies with legal standards and guidelines. Will add professional charges and other charges as necessary for accurate reimbursement of services.
• Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS codes.
• Reviews all reimbursement claims for completeness and accuracy before submission to minimize claim denial.
• Provides guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines. When necessary, queries appropriate providers, nursing staff, or other ancillary departments for missing or incomplete documentation in the chart. Queries will be compliant, non-leading, and respectful.
• Maintains an accuracy of at least 95%, calculated on a sample of at least 30 records per quarter.
• Recognizes and reports problems, issues, and/or discrepancies with procedures and/or patient's medical records for clarification and/or follow-up.
• Responds to emails and notifications from the Business Office regarding denials. Research the patient record for additional information to support the claim.
• Assist with record requests as necessary.
• Reviews all records for appropriate and complete orders.
• Educates and advises staff on proper code selection, documentation, procedures, and requirements.
• Other duties as assigned and necessary.
• Assists in identifying training needs for physicians and support staff to improve skills in the collection and coding of quality health data.

Required Skills/Abilities:

• Knowledge of all applicable coding guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines; English grammar and usage.
• Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.
• Ability to read and interpret medical procedures and terminology.
• Ability to exercise independent judgment.
• Excellent written and verbal communication skills to maintain working relationships with providers and other staff.
• Ability to maintain confidentiality.

Education and Experience:

• 7-10 years of relevant experience
• Inpatient and Swing bed coding experience
• OP Coding experience: ED, Surgery (Podiatry, Orthopedics, ENT, GI) and Urgent Care
• Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), and Registered Health Information Administrator (RHIA) issued by the American Health Information Management Association; and/or,
• Certified Coding Professional (CPC) and Certified Inpatient Coder (CIC) issued by the American Academy of Professional Coders
• Cerner knolwedge preferred
• Auditing knowledge preferred

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.