Medical Coder

Medical Coders play a critical role in the healthcare industry by accurately translating medical records and healthcare services into standardized codes. These codes are used for billing, insurance claims, and data analysis, ensuring proper reimbursement and compliance with regulatory guidelines.

Responsibilities:

• Medical Record Review: Review patient medical records, including physician notes, laboratory reports, and diagnostic information, to extract relevant details for coding.
• Code Assignment: Assign appropriate diagnostic codes (ICD-10-CM) and procedural codes (CPT or HCPCS) to describe the patient's conditions, treatments, and services provided during their healthcare encounter.
• Compliance: Ensure coding compliance with current healthcare regulations and guidelines, including the Health Insurance Portability and Accountability Act (HIPAA).
• Data Entry: Enter coded information into electronic health records (EHRs) or billing software systems accurately and efficiently.
• Quality Assurance: Perform regular quality audits to review coded data for accuracy and completeness. Correct coding errors as needed.
• Insurance Claims: Prepare and submit insurance claims based on coded data to ensure timely and accurate reimbursement.
• Revenue Cycle Management: Assist with revenue cycle management by optimizing coding processes to minimize claim denials and delays in reimbursement.
• Education: Stay updated on changes in coding guidelines, regulations, and industry standards through continuous education and training.
• Communication: Collaborate with healthcare providers, billing staff, and insurance companies to resolve coding-related issues and discrepancies.
• Reports and Analytics: Generate reports and analyze coded data to identify trends, patterns, and areas for improvement in healthcare services and billing processes.

• Certification as a Certified Professional Coder (CPC) 
• Strong knowledge of medical terminology, anatomy, and physiology.
• Proficiency in coding systems, including ICD-10-CM, CPT.
• Attention to detail and accuracy in code assignment.
• Understanding of healthcare billing and reimbursement processes.
• Familiarity with electronic health records (EHR) and healthcare information systems.
• Analytical and problem-solving skills.
• Excellent communication and teamwork abilities.
• Ability to maintain patient confidentiality and adhere to ethical standards.