Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations.
Essential Functions
-Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information.
-Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies.
-Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes.
-Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials.
-Utilize coding software, encoders, and electronic health record systems to facilitate the coding process.
-Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives.
-Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges.
Education
High School Diploma or equivalent required
Associate's Degree in Medical Billing and Coding preferred
Licenses and Credentials
Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred
Experience
3+ years of Medical Coding Experience required
Knowledge, Skills and Abilities
In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing.
Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations.
Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes.
Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding.
Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff.
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.