The Medical Coder II position performs adequate coding services to the organization for achievement of reimbursement and compliance with correct coding guidelines. This individual requires skills in the sequencing of diagnosis/procedure codes to optimize reimbursement.

ESSENTIAL DUTIES AND RESPONSIBILITIES 

• Responsible for the evaluation of medical documentation for proper assignment of ICD10-CM/CPT-4 codes and the preparation of claims.
• Seeks clinical documentation and makes coding recommendations to physicians based on their overall medical observation and documentation of medical records.
• Provide Physician training on MRA/HEDIS coding and medical documentation guidelines.
• Ensures medical records for accuracy and completion through pre audit and post audit processes to adequately code for all services to achieve reimbursement in accordance with correct coding guidelines.
• Completion of 30 medical record abstracts daily and provides coding recommendations to physicians.
• Provides PCP MRA/HEDIS coding support, education, and training.
• Monitor coding changes to ensure most current information is available.
• Assists with chart reviews/audits performed by health plans.
• Looks for new problem areas, trends, etc.
• Works HCC/HEDIS Care Gap Reports.
• Expected to maintain up to date coding innovations that can improve their workflow.
• Maintenance, reconciliation, and completion of PCP coding recommendations-Level 1 claims that have been corrected by physician.
• Other duties as assigned.

EXPERIENCE AND REQUIRED SKILLS

• High School Diploma or equivalent required.

• Minimum of 3 years of medical coding experience with acquired progressive responsibility preferred.

• Strong organizational skills and high attention to detail.
• Strong collaboration and relationship building skills.
• Required to have a command of the English language and be proficient with grammar, spelling and verbal skills to communicate with patients, providers, and staff in written and oral communication.

• Must be proficient be proficient in Microsoft Office and knowledge with computers, scanners, etc.
• Experience with Patient Financial Systems and Electronic Medical Records.
• Good communication skills.
• Ability to learn new tasks and concepts.
• Bilingual English/Spanish preferred.

IMC Health provides equal employment opportunity to all applicants and employees. No person is to be discriminated against in any aspect of the employment relationship due to race, religion, color, sex, age, national origin, disability status, genetics, citizenship status, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.