Professional Coder

Position Summary

A variety of soft skills and experience may be required for the following role Please ensure you check the overview below carefully.

The medical coder will review and analyze content of the medical record to accurately assign CPT / HCPCS / ICD-10 codes and modifiers according to the National Correct Coding Initiative Guidelines. The coder will have a full understanding of the coding process and act as a liaison between the coders and billing specialists, coding & compliance supervisor. The coder will be a resource and expert on all coding related denials for any billing specialist. The coder will keep current with coding and payer changes through participation in educational opportunities.

This is a remote position; however, team members would be required to come onsite for mandatory meetings and trainings.

This position must work at least four (4) hours between the hours of 8am-5pm, with a start time no earlier than 5am and a stop time no later than 10pm. This set schedule is required in case communication is needed during provider office hours.

Essential Functions

• Completes all Charge Review, Claim Edits, Insurance Coding Denial WQs in EPIC.
• Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information significant reportable elements and complications.
• Researches and analyzes data needs for reimbursement.
• Analyzes medical records and identifies documentation deficiencies.
• Reviews and verifies documentation to support diagnoses, procedures, and treatment results.
• Assigns codes and modifiers for reimbursement, research, and compliance with regulatory requirements utilizing NCCI guidelines.
• Follows coding conventions and serves as coding consultant to providers / clinicians.
• Identifies discrepancies, potential quality of care, and billing issues.
• Serves as a resource and subject matter expert to other coding and billing staff.
• Fills in for other coding staff when needed.
• Handles special projects as needed.

Work Experience

Education

Degree Level Required : High School

High School diploma or G.E.D. Associate’s degree preferred.

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