Professional Coder I

Responsibilities

• Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed.
  • Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material.
  • Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy.
  • Assigns diagnostic and procedural codes for physicians in the inpatient, outpatient, and observation setting.
• Identifies any and/or all complications or comorbidities.
  • Applies sequencing guidelines based on medical record information provided according to official coding rules.
  • Assesses the appropriateness of medical record documentation to ensure that it supports the procedure(s), diagnosis', as well as complications and/or comorbid conditions documented.
  • Consults with the appropriate provider to clarify medical record information.
• Assesses the appropriateness of medical record documentation to ensure that it supports the procedure(s), diagnosis', as well as complications and/or comorbid conditions documented.
  • Consults with the appropriate provider to clarify medical record information.
  • Retrieves any and all records corresponding to surgical cases including laboratory/path reports to ensure accurate assignment of ICD-10-CM and CPT-4 codes.
  • Ensures accurate, correctly coded information is entered into Epic.
• Answers provider/clinician questions regarding coding principles.
  • Affords assistance with coding queries for claims appeals and resolution.
  • Refer ancillary department coding questions to Professional Coding Manager.
• Remains abreast of developments in medical record technology by pursuing a program of professional growth and development, attending educational programs and meetings, reviewing pertinent literature and so forth.
  • Utilizes professional affiliations, etc., in order to maintain current in professional developments.
  • Attends all pertinent coding seminars and manager assigned training.
  • Utilize all available hospital-provided electronic resources.
• Works collaboratively with appropriate team members to recommend strategies for process improvement.
  • Assists in responses to billing review requests.
• Abides by Standards of Ethical Coding as set forth by American Health Information Management Association (AHIMA).
• Maintains coding, quality and productivity standards.

Qualifications

• Minimum Education: - Preferred Equivalent to an Associate's Degree in Medical Information Technology (with course work in medical terminology, anatomy, physiology, disease processes, ICD-10-CM coding required and prospective payment preferred).
• Minimum Work Experience: Two to three (2-3) years in a surgical practice preferred.

Required Certifications

• Certified Coding Specialist - Physician Based - American Health Information Management Association (AHIMA)
• Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC)