Coder

Pay: Base Wage starting at $15.65; increased based on experience

Incentive Eligible Position: Yes

Summary of Duties:

A medical coder is a trained medical professional who uses specialized codes and alphanumeric diagnostic (ICD-10 CM, ICD-10 PCS, CPT and HCPCS) to record and interpret information about health conditions of patients. The medical coder follows the ICD-10 CM Official Coding Guidelines when entering the appropriate diagnostic and procedural codes to individual health information for data retrieval, analysis and claims processing.

Essential Functions:

1. Responsible for assignment of diagnosis/procedure codes using ICD 10 CM/PCS, CPT/HCS in various settings and for a wide range of ages from neonate to geriatric utilizing the OPTUM encoder.

2. Validates coding accuracy using clinical information found in the health record

3. health record documentation using knowledge of anatomy, physiology, clinical disease processes, pharmacology, and medical terminology to support the diagnosis and reflect clinical findings, and discharge status of patient.

4. Consults with providers through queries to obtain further clinical information to assist with code assignment.

5. Validates reimbursement classification system assignments.

6. Assists in the facility's billing process.

7. Utilizes common software packages such as spreadsheets, information systems and e-mail.

8. Understands the role of various providers and disciplines throughout the continuum of care.

9. Spends 95% of the time completing coding functions.

10. In facility-wide adherence to health information services regulatory requirements.

11. Verify DRG assignment based on PPS definitions and APC assignment based on OPPS definitions

12. Performs E/M coding and charge capture for both the facility and physician.

13. Assist with education of physicians and staff regarding reimbursement methodologies and documentation rules and regulations related to coding.

14. Recognize UB data elements and manage unbilled, denied or suspended accounts

15. Apply reimbursement methods for billing or reporting; interpret LMRP or payer policies to determine coverage.

The above statements are intended to describe the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

Skills Abilities:

1.Ability to communicate clearly and effectively with all levels

2.Ability to complete competency for CCS and CPC.

3.Ability to perform simple mathematical equations.

4.Ability to prioritize and complete multiple tasks simultaneously.

5.Effective oral and written communication skills.

Working Conditions:

1.Exposure to distressed patients, families or visitors.

2.Possible exposure to inside environmental conditions.

Physical Demands:

1.Requires standing, sitting or walking for up to 8 hours or longer per workday.

2.The ability to lift up to 50 lbs.

Qualifications:

1.CCS, CPC, A & P required

2.High school graduate or equivalent.

3.Experience with medical terminology.

Preferred Qualifications:

1.2+ years of experience

2.2 or 4 year Degree