Medical Coder and Auditor

CNY Family Care's commitment to excellence sets us apart and guides us as we provide care for our community. The Medical Coder and Auditor will be responsible to conduct prospective audits of coding and billing; analyze physician and provider documentation in outpatient office health records; correct evaluation and management (E/M) service levels, appropriate procedure codes, and any necessary modifiers. 

Medical Coder and Auditor Responsibilities:

• Navigate the patient health record, office visit notes, and procedure reports in the determination of diagnoses, reason for visit, procedures, and modifiers to be coded.
• Code outpatient records utilizing coding books, online tools, and references, in the assignment of ICD, CPT, and HCPCS codes and modifiers.
• Document individual encounter audit findings and communicates results to providers.
• Access charge work queues to validate and assign charges.
• Perform all required EMR functions as efficiently as possible and according to procedure.
• Run the delinquent data reports for unsigned charts to ensure all applicable accounts have been received, coded and billed in accordance with practice standards.
• Utilize EMR reports and/or communication tools to track missing documentation or queries that require follow-up to facilitate coding in a timely fashion.
• Maintain current knowledge of changes in Outpatient coding and reimbursement guidelines and regulations e.g., new modifiers.
• Maintain CEUs as appropriate for coding credentials as required by credentialing associations.

Medical Coder and Auditor Qualifications:

• Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate’s degree in Health Information Technology or a related field or an equivalent combination of years of education and experience is required.
• Certified Professional Coder (CPC), Certified Coding Specialist-Physician-based (CCS-P), Certified Outpatient Coder (COC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) is required.
• Two (2) years of outpatient physician office evaluation and management (E/M) coding is required.
• Candidates with previous outpatient physician office evaluation and management (E/M) auditing experience highly prioritized
• Medent EMR experience candidates highly prioritized