Medical Coder (225-817)

A Medical Coder plays an integral role in the healthcare industry, functioning as the bridge between healthcare practitioners and billing offices. Their main responsibility involves transforming healthcare diagnoses, procedures, and services rendered into universal medical alphanumeric codes. This position demands precision and an eye for detail as these codes are used in claim submissions to insurance companies, ensuring that healthcare providers receive appropriate reimbursements for their services. Beyond coding, Medical Coders must remain abreast of coding standards and healthcare regulations, maintaining accuracy and compliance in all documentation. A proficient Medical Coder contributes significantly to the administrative efficiency of healthcare services and plays a crucial role in patient data management and billing accuracy.

Responsibilities

• Translate medical diagnoses and procedures into standard medical codes using ICD-10-CM, CPT, and other coding systems.
• Review patient records and documents to ensure accuracy and completeness before coding.
• Coordinate with healthcare providers to clarify information as needed for accurate coding.
• Submit accurate and complete medical codes for billing purposes and insurance claims processing.
• Stay updated with changes in coding standards, billing regulations, and insurance guidelines.
• Conduct coding audits and reviews to ensure compliance and identify discrepancies or errors.
• Engage in continuous education to maintain certifications and enhance coding expertise.
• Update and manage patient databases, ensuring clarity and accuracy of all health records.
• Communicate with insurance companies to resolve any issues related to coding and claims.
• Maintain patient confidentiality and comply with all healthcare privacy regulations, including HIPAA.
• Assist in developing coding policies and procedures to enhance departmental productivity.
• Participate in meetings and workshops to stay informed about healthcare policies and practices.

Requirements

• Associate's degree in Health Information Technology or related field preferred.
• Professional certification in medical coding such as CPC, CCS, or equivalent required.
• Minimum of one year of experience in medical coding within a healthcare setting.
• Proficiency with standard coding systems including ICD-10-CM, CPT, and HCPCS.
• Strong attention to detail and ability to maintain high levels of accuracy.
• Excellent communication skills for interacting with healthcare providers and insurance companies.
• Ability to work independently and manage time effectively to meet deadlines.