• Reviews, analyzes and abstracts physician/other documentation for diagnoses, procedures, ancillary testing, medications, laboratory and other services provided. Communicates with physicians and other health care staff to obtain missing information or to clarify existing information.
• Assigns and/or audits International Classification of Diseases 10-CM (ICD-10) diagnostic and procedural codes, Current Procedural Terminology (CPT) codes with modifiers, and other applicable codes. Groups codes and completed product into payment group. Analyzes information for optimal and proper reimbursement. Ensures compliance with all appropriate coding, billing and data collection regulations and procedures. Uses appropriate software to validate information.
• Performs daily and weekly account audits from claim edit WQs, entering ICD-10-CM, CPT or HCPCS codes as needed to complete accounts into billing status. Researches and resolves problems referred by coders.
• Provides training and serves as a general resource to assist other coders and members of department staff. Participates in continuing education opportunities to maintain credentials, as necessary. Provides information to physicians and other healthcare staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
• Utilizes a variety of software (e.g. WebCIS, MRE Optum, MS Office, etc.) to compile and validate medical information. Reviews updated Medicare, AHA coding clinics, CPT Assistants and ensures that all changes and/or updates are understood.

Required

• Associate's Degree or a combination of experience and education.

• Must hold a current certification or registration in medical coding as issued by the American Health Information Management Association. Accepted credentials are: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS).

• One year of work experience performing medical coding

Preferred

• Bachelor's Degree