Certified Medical Coder

Medical Coder – Certified

Williamsville, NY

Roswell Park Care Network has an exciting opportunity for Medical Coders to join our team in Williamsville, NY. The positions are hybrid and only require one day in the office each week!

As a leading provider of oncology and specialty care in community physician practices, Roswell Park Care Network is committed to delivering exceptional patient care and pioneering innovative treatment solutions.

The Medical Coder is responsible for reviewing medical records to assure proper billing of the medical service, comparison of physician chosen CPT and ICD-10 codes to the physicians' documentation to substantiate the level of coding, physician services to include identification of professional services and complete review of medical record. Claim denials received for coding errors, refund requests, etc., the coder is responsible to send written appeals to the insurance payer for adjudication and follow-up for payment status within the 90-day timely filing limit of the insurance payer.

Responsibilities:

• Meet coding accuracy standards within 90% to 95% as well as coding productivity standards.
• Coders will review, re-code and appeal denials for all specialties including Inpatient, outpatient, physician, pathology, and infusion charts, as necessary.
• Review the discharge summary, history and physical, physician progress notes, consultation reports, operative records, inpatient hospital record to accurately assign a diagnosis and / or procedure.
• Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD-10-CM and CPT codes.
• Utilize computer applications and resources essential to completing the coding process efficiently.
• Responsible for correcting any data found to be in error after reviewing the medical record and comparing with system entries. Including, investigating payer coding rules to complete insurance claim appeals, submitting supporting documentation, tracking, and following up accordingly to ensure claim is processed.
• Assign Risk Adjustment diagnoses by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology, and pathology.
• Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM and CPT codes.
• Reviews state and federal Medicare reimbursement claims for completeness and accuracy before submission to minimize claim denial.
• Reads bulletins, newsletters, and periodicals and attends workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation.
• Educates and advises staff on proper code selection, documentation, procedures, and requirements.
• Identifies training needs, prepares training materials, and support staff to improve skills in the collection and coding of quality health data

Education / Certification / Experience:

• CPC (Certified Professional Coder) or CMC (Certified Medical Coder) required
• 1-3 years experience with specialty coding (e.g., Urology, ENT, Dermatology, Pulmonology, Breast health & Oncology).
• Experience with EMR and billing systems, such as Medent & ONCO preferred.
• Working knowledge of medical terminology, CPT, and ICD-10 coding
• Familiarity with medical office procedures

Salary: $23.00-30.00 per hour, based on experience, skills, internal equity, and qualifications.