Medical Coder

2 Months ago • All levels

Job Summary

Job Description

The Medical Coder is responsible for reviewing, analyzing, and interpreting clinical documentation from Ancillary, Laboratory, and Pathology settings. They will apply ICD-10-CM and CPT codes according to coding conventions, AHA policies, Medicare and other payer requirements, and official guidelines. This includes assigning correct ASC/APC modifiers for appropriate reimbursement and revenue codes for CPT codes. The role also involves resolving edit accounts, re-classed accounts, and late charges, notifying supervisors of unresolved accounts. The coder must ensure all clinical tests meet medical necessity standards. Proficiency in computer skills (Microsoft Office Suite), medical coding knowledge, and understanding of HIPAA regulations are essential.
Must have:
  • ICD-10-CM & CPT coding
  • Ancillary, Lab, Pathology coding experience
  • AHA coding policy & procedures knowledge
  • Medical necessity understanding
  • HIPAA Privacy & Security knowledge
  • CCS, CCS-P, CCA, COC, or CPC certification

Job Details

Description

Essential Responsibilities:
 

Reviews, analyzes and interprets clinical documentation in Ancillary, Laboratory and Pathology setting and applying ICD 10 CM and CPT codes in accordance with ICD10 and CPT coding conventions, AHA coding policy & procedures, requirements of Medicare and other payer specifications and official coding guidelines as outlined by governing bodies. Assigns correct ASC/APC modifiers to ensure appropriate reimbursement. Assigns correct revenue codes for all CPT codes, when applicable. Resolves edit accounts, re-classed accounts, and late charges and notifying supervisor of accounts which cannot be resolved in a timely manner through normal coding encounters. Ensures all clinical tests performed meet medical necessity according to local and national policies.

 
Qualifications: Knowledge, Skills, and Abilities:
 

Professional Coding Experience in Ancillary, Laboratory and Pathology setting encounters. Ability to multi-task in a fast paced working environment. Ability to work independently in a production environment Ability to build relationships both internally and externally. Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Word, Excel, PowerPoint, Internet browsers, etc. Demonstrated knowledge of medical codes, coding conventions and rules. Demonstrated experience with coding systems. Working knowledge of HIPAA Privacy and Security Rules.

 
Certifications (One of the following Required):
 
CCS, CCS-P, CCA, COC or CPC

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