Opportunity
Our client relies on powerfully insightful data to ensure the delivery of excellent healthcare services, and we’re seeking an experienced medical coder to deliver this insight daily. The ideal candidate will have thorough knowledge of anatomical and medical terminology, as well as natural curiosity and an analytical mindset. As the coder mines and interprets patient medical records, transcriptions, test results, and other documentation, we’ll rely on them to ask questions, connect the dots, and uncover information that may be difficult to find — all to ensure a smooth billing process. The medical coder will abide by standard protocols of the profession while using their own methods to compile the most accurate information and promote organizational growth.
Objectives of this role
- Manage high-quality, timely coding of diagnoses and procedures for inpatient and outpatient accounts, using ICD-10, CPT-4, and HCPCS classification systems
- Work closely with physicians, technicians, insurance companies, and other integral parties to uncover and discuss coding analysis results
- Develop and execute policies and procedures that affect immediate operations and may also have organization-wide impact
- Analyze issues in which the situation or data requires in-depth knowledge of organizational objectives
- Implement strategic policies by selecting methods and evaluation criteria for accurate results
Responsibilities
- Gather physician background information from various resources for reporting purposes
- Analyze medical malpractice claims by identifying issues, events, diagnoses, and procedures that led to result
- Prepare summaries and assign the appropriate codes
- Review claims to formulate a synopsis of facts, and collaborate with claims examiners as needed
- Make corrections to draft reports after physician review and submit approved reports to managers in a timely fashion
- Interact with claims staff, attorneys, and physicians regarding reports
Required skills and qualifications
- 4+ years of Inpatient Hospital Coding background; ICD-10-CM AND ICD-10- PCS. Certified by AHIMA as a certified coding specialist (CCS).
- In coding Medical/ Surgical charts including but not limited to spinal surgery, cardiology- TAVR, ECMOs, Impellas, Interim coding, and NICU newborn.
- Knowledgeable of coding rules and requirements to include clinical classification systems (such as current versions of ICD-10 and PCS), complication and comorbidity Conditions/Major complication and comorbidity Conditions (CC/MCC), Medicare Severity Diagnosis Related group (MS-DRG) structure, and Present on Admission (POA) indicators.
Preferred skills and qualifications
- Associate’s degree (or equivalent) in health information systems or related field
- Professional credential for medical practices, such as CPC (Certified Professional Coder)
- Experience in using the XIFIN billing system
- Epic
- Optum CAC
