Job Description
Job Description
Job Summary
The Medical Coder is responsible for accurately reviewing patient health records and assigning standardized diagnosis, procedure, and service codes in accordance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS, payer requirements, and organizational policies.
This role supports accurate reimbursement, regulatory compliance, quality reporting, and the overall integrity of health information. The Medical Coder must maintain a high level of accuracy, productivity, confidentiality, and compliance with applicable healthcare standards.
Key Responsibilities
- Assign accurate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with official coding guidelines and regulatory requirements.
- Review clinical documentation to ensure coding accurately reflects diagnoses, procedures, treatments, and services provided.
- Abstract clinical and demographic information from patient records into health information and billing systems.
- Review medical necessity and ensure coding supports appropriate and compliant reimbursement.
- Review physician documentation and query providers when clarification or additional documentation is required.
- Evaluate claims in the Quadax work queue and make appropriate corrections to the medical record and claim.
- Utilize the 3M Coding System to support accurate and compliant coding.
- Assist with denial management by reviewing denied claims and recommending coding corrections when appropriate.
- Participate in internal and external coding audits.
- Maintain a coding accuracy rate of 95% or higher while meeting established productivity and turnaround-time expectations.
- Maintain compliance with HIPAA, CMS regulations, payer requirements, and organizational policies.
- Maintain the confidentiality and security of protected health information (PHI).
- Work closely with Madison Parish Hospital (MPH) providers and other clinical staff regarding coding questions and documentation.
- Maintain current coding knowledge, credentials, and competencies through continuing education.
- Perform other duties as assigned by the HIM Director.
Required Qualifications
- Minimum of 2 years of medical coding experience, or an equivalent combination of education, training, and experience.
- Working knowledge of ICD-10-CM diagnosis coding.
- Knowledge of medical terminology, anatomy, and physiology.
- Basic knowledge of electronic medical records (EHR) systems.
- Ability to interpret clinical documentation and apply appropriate coding guidelines.
- Ability to work independently, prioritize tasks, and meet deadlines and turnaround-time requirements.
- Ability to communicate effectively and work collaboratively with Madison Parish Hospital providers and clinical staff.
- Successful completion of a medical coding, health information management, healthcare administration, or related certification program.
Required Certification
Candidates must hold one of the following certifications:
- CCS
- CCA
- RHIT
- RHIA
- CPC
- CPC-A with appropriate supervision
Education
- High school diploma or equivalent — Required
- Associate degree in Health Information Management or a related field — Preferred
Preferred Skills & Abilities
- Strong knowledge of ICD-10-CM, CPT, HCPCS Level II, and official coding guidelines.
- Familiarity with CMS, OIG, and payer-specific coding requirements.
- Strong attention to detail and commitment to coding accuracy.
- Analytical and critical-thinking skills for interpreting complex clinical documentation.
- Excellent written and verbal communication skills.
- Strong time-management and organizational skills.
- Proficiency with coding software and EHR systems.
- Experience with 3M Coding System and Quadax preferred.
- Ability to consistently maintain a 95% or higher coding accuracy rate.