Certified Coder (PRN)

Responsibilities

• Conduct daily coding, auditing, and Diagnosis-Related Group (DRG) validation of assigned encounters to ensure accuracy and compliance with outpatient standards.
• Review and provide recommended corrections of billed services for medical records, ensuring accuracy and compliance with current coding guidelines and regulations.
• Perform DRG validation to ensure appropriate assignment based on clinical documentation and coding.
• Audit billed services and provide recommended corrections related to clinical documentation to maintain coding integrity.
• Assist in reviewing and responding to payer and governmental audits of billed services.
• Stay current with and apply new coding guidelines and codes, maintaining expertise in CPT, HCPCS, and ICD-10 coding systems.
• Meet established daily accuracy and production standards as per department policy.
• Collaborate with healthcare team members to ensure continuity of services and clarity in clinical documentation.

Requirements

• High school diploma or GED (required).
• One or more of the following credentials:
  • Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA); or
  • Certified Professional Coder (CPC) and Certified Outpatient Coder (COC) through the American Academy of Professional Coders (AAPC).
• At least 1 year of inpatient medical coding with DRG validation work experience.
• Strong analytical, interpersonal, and communication skills.
• Ability to produce detailed, comprehensive documentation and reports.
• Passing scores on job-related pre-employment assessments.

Preferred Qualifications

• Experience in coding or medical billing quality control.

Expectations

Comfortable with remote work arrangements and virtual collaboration tools.

Physical demands include extended periods of sitting, computer use, and telephone communication.