Job Description
Job Description
Salary Range: $26.00 to $31.00 an hour
By adhering to Connecticut State Law, pay ranges are posted. The pay rate will vary based on various factors including but not limited to experience, skills, knowledge of position and comparison to others who are already in this role within the company.
COVID-19 and Flu Vaccine Considerations
Masks are optional for employees, visitors, patients, vendors, etc. All employees are strongly encouraged and recommended to obtain the COVID-19 vaccination routinely. Proof of annual flu vaccination is required for all employees.
PACT MSO, LLC is a management service organization that supports a large multi-specialty practice of providers. We are currently looking for an experienced Medical Coder who will be working in Branford Monday through Friday from 8:30am to 5:00pm. This is not a remote position.
Summary
The coder reviews, analyzes, and codes diagnostic and procedural information in the medical record that determines Medicare, Medicaid, and private insurance payments. The primary function of this position is to assign ICD10, CPT, and HCPCS coding based on provider documentation to ensure accurate reimbursement and tracking of services provided. The coding function ensures compliance with established coding guidelines, third party reimbursement policies, and regulations for a busy Multi-Specialty Practice.
Essential Functions
• Thorough understanding of the contents of medical records in order to identify information to support coding.
• Extracts pertinent information from patient medical records. Assigns ICD10CM, CPT/HCPCS codes and modifiers.
• Reviews and analyzes medical records to identify relevant diagnoses and procedures for distinct patient encounters within a Multispecialty Practice.
• Translates/extracts diagnostic and procedural phrases into coded form - the accurate translation process requires understanding and interpretation of medical reports, industry standard and payer specific coding conventions and guidelines.
• Reviews denials for coding lapses and suggests coding changes for corrective and preventive action.
• Notifies a Manager/Supervisor or designated individual when reports are incomplete and code assignments are not straightforward or documentation is inadequate and updates relevant logs.
• Keeps updates of coding guidelines, federal reimbursement requirements, and changes to third party reimbursement policies.
• Abides by Standards of ethical coding as set forth by American Academy of Professional Coders (AAPC} and American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Performs other related duties as required.
Skills and Knowledge
• Demonstrate expertise in coding Evaluation and Management (E/M) visits across multiple specialties, ensuring accurate level selection based on documentation guidelines and supporting providers in optimizing clinical notes for compliance and reimbursement.
• Maintain up-to-date knowledge of billing and coding regulations across multiple specialties by actively engaging in continuing education, certifications, and industry updates to ensure accurate and compliant coding practices.
• Identify and facilitate educational opportunities for billing and clinical staff, tailoring training to address specialty-specific documentation and coding challenges.
• Research new procedures and clinical documentation requirements, providing clear coding guidelines and educational resources to support accurate billing and improve provider documentation across specialties.
• Thorough understanding of the contents of multi-specialty medical records in order to identify information to support coding.
• Thorough knowledge and experience in EHR, preferably EPIC.
• Basic knowledge of anatomy and physiology of human body and diseases in order to understand etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and procedures to be coded.
• Basic understanding of claims form and reimbursement process
• Understanding of local medical policies of carriers and Medicare.
Education and Experience
• Education: High School degree or equivalent required, Associates preferred.
• Must possess and maintain coding certification from the American Academy of Professional Coders (CPC).
• Experience: Minimum 3 years’ experience as a coder in a multi-specialty physician group.
• Experience: Strong coding and reimbursement background.