Under direction of the Coding Manager, the primary responsibility of the Coder/Analyst is to ensure that codes representing current International Classification of Diseases, 9th Revision (ICD-9), or 10th Revision (ICD-10), Current Procedural Terminology (CPT), and the Healthcare Common Coding System (HCPCS) accurately reflect documented services by applying a demonstrated knowledge of anatomy, physiology and medical terminology as well as compliant coding rules and regulations, including medical necessity and modifiers. Additionally, the Coder serves as the key resource to the Chief and Administrative Director and/or Manager regarding coding changes affecting assigned clinical areas, ongoing coding reviews of providers, and trends associated with coding utilization and optimization, denial management, reimbursement, and customer services issues. The Coder is ultimately responsible for efficient charge capture processes, knowing and meeting expected targets at sufficient accuracy rates as measured by Transaction Editing System (TES) edits, claim action report volumes, and denials. The Coder will identify potential compliance concerns and/or barriers toward timely completion of all tasks to the Coding Manager and will endeavor to work in collaboration with colleagues in Coding, Clinical Departments, Health Information Management, Information Technology, and Finance toward viable solutions.
- High school diploma
- Associates degree preferred
Â Â One year experience in medical coding or medical billing or a CPC or CCA Apprentice certification
- CPC or CCS certification must be obtained within one year from the date of hire
- General familiarity with CPT, HCPCS, ICD-9 and ICD-10 codes, anatomy and physiology and medical terminology
- Physical Requirements:
- This position involves extensive work at computer station.
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