Medical Coder (225-831)

A Medical Coder plays a critical role in the healthcare industry by ensuring accurate translation of medical diagnoses, procedures, and treatments into universally recognized medical codes. These codes are essential for both healthcare providers and insurance companies to efficiently process billing and claims. A Medical Coder must possess a keen attention to detail and a comprehensive understanding of medical terminology, anatomy, and coding systems such as ICD-10-CM, CPT, and HCPCS. They work in various healthcare settings, including hospitals, clinics, and insurance companies. The position is vital for improving healthcare revenue cycles and ensuring compliance with insurance standards and regulations. Medical Coders continuously update their skills to keep up with changing coding certifications and healthcare regulations, and they prioritize accuracy and confidentiality while handling sensitive patient information.

Responsibilities

• Accurately assign and sequence appropriate medical codes for diagnoses and procedures.
• Collaborate with healthcare providers to ensure accurate documentation of medical services.
• Review patient medical records to identify and extract relevant information for coding.
• Ensure compliance with HIPAA guidelines and maintain patient confidentiality at all times.
• Communicate with insurance companies to resolve billing discrepancies and claim denials.
• Stay updated with changes in medical coding standards and regulations.
• Support billing department by providing accurate coding as needed for reimbursement processes.
• Generate reports and analyze trends in coding and billing activities for management review.
• Train and mentor new staff on coding best practices and regulatory compliance.
• Utilize specialized coding software to enhance accuracy and efficiency in coding processes.
• Participate in audits and provide feedback for improving documentation and coding accuracy.
• Assist in the development and maintenance of coding policies and procedures.

Requirements

• Certification as a Certified Professional Coder (CPC) or equivalent credential preferred.
• Strong understanding of ICD-10-CM, CPT, and HCPCS coding systems required.
• Proven experience in medical coding in a healthcare setting preferred.
• Exceptional attention to detail and accuracy in code assignment essential.
• Proficient in using electronic health records (EHR) and coding software applications.
• Excellent analytical skills to interpret healthcare documentation and data.
• Strong communication skills for effective collaboration with healthcare professionals.
• Ability to maintain confidentiality and handle sensitive patient information responsibly.
• Willingness to engage in continuous learning and professional development in coding.