Certified Medical Coder

Job Description

Job DescriptionDescription:

The Certified Medical Coder is responsible for analyzing medical records and identifying documentation deficiencies. They serve as subject matter experts for other coders within the billing department and review documentation to verify diagnoses, procedures, and treatment results.

JOB RESPONSIBILITIES

· Communicate effectively with individuals at all levels of the organization, demonstrating strong written and written communication skills.

· Perform CPT and ICD-10 coding under the direction of the Coding Lead and Revenue Cycle Manager, ensuring accuracy and maximum reimbursement.

· Apply knowledge of anatomy, physiology, disease processes, medical terminology, coding guidelines for outpatient and ambulatory surgery, and documentation requirements.

· Work both independently and as part of a team, demonstrating strong attention to detail and process orientation.

· Manage multiple tasks, organize and prioritize work assignments, and maintain accuracy under pressure.

· Review and code both electronic and paper medical records.

· Verify the completeness and accuracy of diagnosis, procedures, evaluations, and management components in medical records.

· Review principal diagnoses, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs using ICD-10, CPT, HCPCS (all levels), and other coding systems as required.

· Conduct quality assurance checks on data prior to transmittal, correcting errors as needed.

· Analyze medical record documentation for consistency and completeness, using established criteria and regulations for coding purposes.

· Ensure that all documents in the medical record contain authorized signatures and accurate patient identification, verifying that the diagnosis and treatment are appropriately documented.

· Meet and exceed productivity goals set by the Coding Lead and department manager.

· Ensure accurate and appropriate sequencing of ICD, CPT, and HCPCS codes and modifiers according to official guidelines.

· Perform additional duties as assigned.

Requirements:

KNOWLEDGE

· Working knowledge of medical billing practices.

· Familiarity with payers, payer polices, and payer engines.

· Knowledge of HIPAA requirements regarding patients and medical records.

· Understanding of medical terminology, basic anatomy, and physiology.

SKILLS

· Proficient in computer skills, 10-key, and other office hardware.

· Strong mathematical skills.

· Excellent written and verbal communication skills.

· Initiative to provide high-quality services and improve practice efficiency.

· Ability to maintain positive working relations with co-workers.

· Effective time management and organizational skills.

ABILITIES

· Ability to interact professionally and courteously with patients, effectively communicate with both patients and vendors, and remain calm under stress.

· Ability to understand and interpret policies and regulations.

· Ability to prepare documents in response to complaints and inquiries.

· Ability to examine documents for accuracy and completeness.

MININUM QUALIFICATIONS

· Certified Professional Coder (CPC) certification required.

· Minimum of two years of practical coding experience; previous dermatology experience is a plus but not required.

· High school diploma or equivalent required.

· Proficient in MS Office (Word, Excel, PowerPoint)

· Knowledge of Medicare Documentation Guidelines.

· Experience in Evaluation and Management (E/M) coding.

· Proficiency in ICD-10 and CPT/HCPCS coding rules.

· Knowledge in using practice EMR, specifically EMA, is a plus.

ADA Requirements: Candidates must be able to perform the essential functions of the position with or without a reasonable accommodation.

Physical Requirements: Tasks require the ability to exert light physical effort in sedentary to light work, which may involve some lifting, carrying, pushing, and/or pulling of objects and materials of light weight (5-10 lbs). Tasks may also involve extended periods of time at a keyboard or workstation.

Work Environment: Essential functions are regularly performed without exposure to adverse environmental conditions.