Job Overview:

A Medical Coder, or Certified Professional Coder, is responsible for reviewing a patient's medical records after a visit and translating the information into codes that insurers use to process claims. Their duties include confirming treatments with medical staff, identifying missing information and submitting forms to insurers for reimbursement. 

Job Duties:

• Complying with medical coding guidelines and policies
• Collecting information from different sources to prepare monthly reports
• Interpreting a patient’s medical chart and assigning the appropriate diagnostic and procedural codes
• Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes
• Identifies discrepancies, potential quality of care, and billing issues.
• Verifying signatures and data
• Assigns CPT, HCPCS, ICD-10 CM, and DRG Codes
• Reviews the claims to make sure they are correct prior to submitting for reimbursement
• Corrects and resubmits denied claims for coding errors
• Assigns codes to diagnoses and procedures, using ICD (International Classification of Diseases), CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System)
• Ensure codes are accurate and sequenced correctly in accordance with the government and insurance regulations
• Follow up with the provider on any documentation that is insufficient or unclear
• Communicate with other clinical staff regarding documentation
• Search for information in cases where the coding is complex or unusual
• Receive and review patient charts and documents for accuracy
• Review the previous day’s batch of patient notes for evaluation and coding
• Ensure that all codes are current and active and in compliance with medical coding policies and guidelines
• Answers questions, advises, and trains providers and staff on medical coding
• Performs patient chart audits and provides coding feedback and education to administration team as needed
• Address and solve client questions and issues
• Maintain knowledge regarding coding and diagnostic procedures
• Follows HIPAA guidelines when accessing and sharing patient information
• Assists lead or supervisor in orienting, training, and mentoring staff
• Informing immediate supervisor of any issues that arise
• All other Duties as Assigned by your immediate supervisor or administration

Job Qualifications:

• Associate Degree in Medical Coding with successful completion of a certificate program (AAPC/AHIMA)
• Previous medical office experience preferred
• Strong knowledge of anatomy, physiology, and medical terminology
• Proficiency in computer skills including typing speed and accuracy
• Commitment to a high level of customer service
• Superior mathematical skills
• Familiarity with ICD codes and CPT codes
• Solid oral and written communication skills
• Working knowledge of medical terminology and anatomy
• Able to work independently or as an active member of a team
• Ability to multitask, prioritize and manage time efficiently
• Ability to maintain a high level of integrity and confidentiality of medical information
• Strict attention to details
• Knowledge of data entry and transcription
• Excellent organizational skills with the prompt ability to manage own workload
• Keep up to date with changes in coding standards and participate in educational opportunities to improve job performance

Continuing Education Materials:

• SGMC will reimburse, upon approval from Admin, any continuing education material necessary for the duties of the position and to meet educational compliance.

Physical Requirements:

• Requires sitting and standing associated with a normal office environment.
• Performs highly complex and varied tasks requiring independent knowledge and its

application to a variety of situations, as well as exercising independent judgement.

• Requires the use of office equipment such as copiers, scanners, computers, telephones,

and fax machines.

• May view computer screens for long periods of time.
• Must be able to prioritize activities when faced with competing demands.
• Occasionally lift/carry up to 50lbs
• Occasionally push/pull up to 40lbs