Medical Coder (225-919)

A Medical Coder plays a pivotal role in the healthcare industry by ensuring that medical billing and coding are performed accurately and efficiently. Their work involves translating medical diagnoses, procedures, and equipment used in patient care into universal codes. This process is crucial for healthcare providers to receive accurate reimbursements from insurance companies and government programs like Medicare and Medicaid. Medical Coders work with various healthcare professionals to gather all necessary information and ensure that the medical records are complete and compliant with federal regulations and insurance policies. Their attention to detail and understanding of the intricacies of medical coding are integral in maintaining the financial health of healthcare practices.

Responsibilities

• Translate healthcare providers' diagnoses and treatments into standardized medical codes.
• Review patient medical records to identify all documented conditions and treatments.
• Ensure coding accuracy and compliance with federal regulations and insurance policies.
• Communicate with healthcare providers to clarify unclear or incomplete documentation.
• Assist in resolving any discrepancies in billing or coding to ensure correct payments.
• Maintain patient confidentiality and adhere to all applicable privacy laws and regulations.
• Keep abreast of coding guidelines and legal requirements regarding medical coding practices.
• Work with billing and insurance teams to ensure claims are processed efficiently.
• Perform audits on medical records to verify coding accuracy and completeness.
• Provide feedback and training to staff on medical documentation improvement strategies.
• Update patient records with new information as it becomes available.
• Manage special projects related to medical coding and reimbursement as assigned.

Requirements

• Certificate in medical coding or a related field is required.
• Experience with ICD-10, CPT, and HCPCS coding is highly preferred.
• Strong understanding of medical terminology, anatomy, and physiology.
• Excellent attention to detail and high level of accuracy in work.
• Familiarity with healthcare insurance and reimbursement processes.
• Proficient in using electronic health records (EHR) and coding software.
• Strong communication skills to work effectively with medical staff and providers.