op medical coder

Under general supervision, the Medical Coder is responsible for abstracting and assigning codes for diagnoses and procedures to both inpatient and outpatient healthcare records with accuracy, and serving as a coding resource to staff.

Responsibilities

• Codes Outpatient Claims by assigning the appropriate E&M, CPT, ICD and USCLS Codes.

• Codes Inpatient Claims so as to derive the most appropriate DRG Codes and severity.

• Codes for all Day cases and Observations with relevant ICD, CPT, HCPCS and Service Codes.

• Codes for all Inpatient and Outpatient approval requests.

• Re-evaluates the cases in terms of coding, at the time of resubmission; to add, delete or change certain codes, as per the available documentation; in order to justify the performed services.

• Provides orientation to new Doctors and Nursing staff, with regards to documentation of cases on the Patient/Medical records.

• Assists Doctors with regards to codes, in order to help them document the cases in a most appropriate manner, so as to include all the essential requirements.

• Provides Coding assistance to the Insurance billing team as per requirement.

• Addresses all Coding queries from the Billing, Laboratory and Radiology departments of the facility.

• Follows up with doctors, with regards to incomplete Medical Record files, in order to complete the same.

• Prepares the facility for the Coding Audits for accreditation and implements all the mandates set by DOH and CCSC.

• Maintains statistical data with regards to Coding and presents the same to the HOD and Management, as and when requested.

• Achieves accuracy in coding so as to attain maximum revenue.

• Assists Auditors at the time of Insurance audits and helps the Insurance Manager in preparing feedbacks and reports for the same

• The coder must clarify ambiguities and highlight inconsistencies found in diagnosis described in the Medical records to physicians with escalation to the HOD. All clarifications must be documented.

• Adhere to the hospitals telephone standards

Qualifications

Any Bachelor degree (preferably with Medical background)