Medical Coder

JOB SUMMARY
Reviews assigned providers’ procedure and diagnosis codes, and makes coding changes as necessary. Provides timely feedback to providers regarding documentation guidelines, coding, and audits. Performs other duties as assigned. May be asked to work weekends and reasonable amounts of overtime when ---------- SENTIAL DUTIES AND RESPONSIBILITIES
• Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.
• Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.
• Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.
• Researches any coding inquiries the provider or medical staff may have, and presents findings to them.
• Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.
• Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare & Medicaid Services (CMS) and contracted payers.
• Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.
• Works with billing partners in developing efficient coding processes and researching denials.
• Responds to customer concerns through coding reviews requested by other departments.
• Conducts provider coding orientation and education sessions and documents all information presented.
• Maintains an in-depth knowledge of Epic ambulatory and hospital modules.
• Works as a team to achieve productivity goals.
CERTIFICATION/LICENSURE
Certified Professional Coder (CPC) or other equivalent coding certification required