Description

Responsible for providing expertise in reviewing and assigning accurate medical codes for diagnoses, 

procedures, and services performed by physicians and other qualified healthcare providers.

Requirements

Minimum qualifications:

High school graduate or equivalent. Associates degree in medical coding or related field preferred. 

Certified Professional Coder (CPC) credential is required; AAPC preferred. One-year FQHC medical billing 

and/or coding experience preferred.

Key Success Factors:

• Working knowledge of current CPT and ICD10 codes and basic medical terminology.

• Skill in operating computer, calculator, copiers, printer, telephone. 

• Establish and maintain positive working relations with coworkers.

• Displays strong organization skills with the ability to prioritize and be detail oriented.

• Proficient in Microsoft Office, including Outlook, Word, and Excel.

• Excellent communication skills, both written and oral

• Demonstrate the initiative to provide quality of service and improve efficiency.

• Ability to perform in a fast-paced environment while being professional, courteous and calm.

• Understand and interpret policies and regulations.

• Ability to compose queries in an understandable manner.

Essential Functions: 

• Verifying and coding of the diagnosis, evaluation and management, procedures or other codes 

required for the completeness and accuracy of the record. 

• Review of electronic medical records initiated by a health care provider.

• Review and verify component parts of medical records to ensure completeness and accuracy of 

diagnosis, operations, and special therapeutic procedures. 

• Codes and/or reviews principal diagnosis, co-morbidities, complications, therapeutic and 

diagnostic procedures, supplies, materials, injections, and drugs with International Classification 

of Diseases (ICD10), Current Procedural Terminology (CPT), Heath Care Financing Administration 

Common Procedure Coding Systems (HCPCS – all levels, and any other coding classification 

systems that may be required). 

• Perform edit checks on data entered prior to transmittal and corrects errors as indicated. 

• Analyze medical record documentation for consistency and completeness for coding purposes 

using established criteria and regulations. 

• Examine all documents in the record for authorized signature and patient identification to 

ensure all documents contain sufficient documentation to support the diagnosis and treatment 

administered, and the results obtained are adequately described. 

• Research and manage coding related queries to clinical staff and provide guidance. 

• Communicates finding and current coding, documentation and billing updates to the Senior 

Compliance Specialist and direct leadership in a timely manner.

• Remains current of trends and changes in the laws and regulations governing medical record 

coding and documentation.

• Demonstrates an understanding for confidentiality to protect the patient and the corporation. 

• Heritage Health staff have an active role in our Patient Centered Medical Home model of care. 

This role is designated as part of the Heritage Health PCMH Care Team.

• Regular and predictable attendance is an essential function of this position.

• Performs other job-related duties as assigned.