Medical Coder Job Description
Medical Coder Duties & Responsibilities
To write an effective medical coder job description, begin by listing detailed duties, responsibilities and expectations. We have included medical coder job description templates that you can modify and use.
Sample responsibilities for this position include:
Medical Coder Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Medical Coder
List any licenses or certifications required by the position: CCS, CPC, RHIT, RHIA, AHIMA, AAPC, HCS-D, ICD, CRC
Education for Medical Coder
Typically a job would require a certain level of education.
Employers hiring for the medical coder job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Medical, Healthcare, Health Information Management, Associates, Health, Education, Health Information Technology, Technical, Life Science, Nursing Program
Skills for Medical Coder
Desired skills for medical coder include:
Desired experience for medical coder includes:
Medical Coder Examples
Medical Coder Job Description
- Obtain prior authorizations from insurance companies in a timely manner for all hematology/oncology treatments and procedures
- Monitor coding work queues for simple visit coding including rehabilitation services
- Enter and/or review charges for provider services
- Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes
- Bring identified concerns to Supervisor or Department Manager for resolution
- Abide by the standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines
- Code information within the Inpatient Unit
- Research coding issues
- Communicate to supervisor any discrepancies, concerns, or questions
- Code charts with highest attention to detail to avoid mistakes
- Reviewing medical procedures as documented by doctors
- Alert physicians, technicians and physician assistants of any discrepancies in documentation
- Consult with physicians concerning difficult to code cases or cases where the diagnosis is vague in order to be able to assign the correct coding nomenclature
- Obtain insurance authorizations for additional services
- Run report to ensure that all charges were captured and billed
- Analyze payment report to ensure that reimbursement is according to contractual agreement and to identify short payments
Medical Coder Job Description
- Systematically review and analyze patient medical records to determine all appropriate diagnosis and procedures performed, and to produce coded abstract for physician billing
- Submission of coded services for billing and or data entry of the coded services for claim submission in accordance with departmental productivity and accuracy standards
- Code charge tickets for all surgical and non-surgical departments
- Review and correct coded outpatient tickets
- Code electronic chart documentation for medical wards and consultation services
- Assists business office management with any special projects related to coding issues or questions that may include medical records audits and other coding/HIM support, as appropriate
- Assists with preparation for accrediting bodies and/or State reviews
- Practices and adheres to the Company’s Code of Conduct philosophy and its Mission and Values Statement
- Conduct and document results of regularly scheduled audits of members
- Oversee medical records for compliance with ICD-10 coding and CMS-HCC Risk Adjustment criteria
- Ability to drive to provider offices in the Daytona and surrounding areas approximately 75% of the time
- CPC, CRC, CCS-P Coding Certification or CPC-A with coding experience
- Ability to drive to provider offices in the Glen Allen/Richmond and surrounding areas approximately 75% of the time
- Ability to drive to provider offices in the Orlando and surrounding areas approximately 75% of the time
- Minimum of 18 months prior medical coding experience
- Training and presentation ability
Medical Coder Job Description
- Develop and implement monitoring programs, policies and procedures and reporting tools
- Learning is a daily part of your role with MedAssets-Precyse – keep your coding knowledge base current with Precyse University, available to all coding colleagues
- Coding and abstracting patient charts
- Communicating with physicians and other personnel when needed
- Detecting and monitoring discrepancies and contact manager for resolution
- Abstract pertinent information from patient records and assign ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT, and/or HCPCS codes
- Review claims, ensure accurate charge capture and review medical necessity for all
- Follow guidelines for coding and documentation to ensure physicians and hospital compliance
- Remain current with coding information to ensure accuracy of codes assigned based on documentation
- Guide, support, and sponsor concurrent clinical coding
- Knowledge of HCPCS, CPT & ICD codes
- Certified Medical Coder with one of the following active certifications combined with a high degree of competency
- Prior experience in a medical office environment
- Knowledge of MRA or HEDIS
- Organization– Able to work independently
- CPC, CPC-A or CCS-P Coding Certification
Medical Coder Job Description
- Acts as a liaison between the clinical and coding functions
- Serve as a resource for coding functions in the Medical Claims Review Unit to ensure proper level of coding and payment of medical claims
- Evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate CPT assignment
- Work with multiple departments to collect all clinical information, medical charts and documents
- Assign appropriate ICD-9 and CPT-4 codes
- Handle coding for 20+ different providers
- Oversee a high volume of claims, invoices, and other coding documents
- Provide support to providers with any coding issues
- Support revenue manager
- Assist manager with maintenance of manuals, newsletters, reference materials
- Minimum of 2 years of experience coding patient records in a hospital HIM departmentt
- 2+ years experience in coding, and medical records
- CPC, CPC-H, CCS-P, or CCS certification required within one (1) year of employment
- Minimum one (1) year experience in ICD-9 and CPT coding for the emergency department preferred
- Ability to function well in a fast paced, production driven environment
- Working mandatory overtime at the direction of management
Medical Coder Job Description
- Exercises knowledge of medical terminology and physiological systems, Medicare coding rules and regulations
- Support Precyse’s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice
- Policies and procedures as evidenced by in-service attendance and daily practice
- Review of inpatient data and reconciliation of billable services including, review of system processing and appropriate escalation and timely communication of errors and omissions and clinical documentation insufficiencies
- Review and resolution of coding related edits and errors that impact claim submission
- Provides feedback to Risk and Recovery leadership on performance improvement opportunities as a result of performance gaps
- Coordinate with program and operations staff, and MMIS IT to update, and maintain ICD logic
- Reviews provider documentation to determine principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures
- Assure appropriate diagnosis and grouper assignment
- Performing initial charge review to determine appropriate ICD-9, ICD-10, and CPT codes to be used to report services to third party payers
- Completion of accredited coding program (Certified Coding Specialist or Certified Professional Coder)
- Certified coder through AHIMA, AAPC, PMI or equivalent
- Minimum of Bachelor’s degree from an accredited university or college experience
- Knowledge of patient insurances
- Minimum high school diploma or equivalent, B.S
- CPC preferred but at least six months previous medical coding experience in a clinic environment is required