At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
The Medical Records Coder II is a certified coder who coordinates and reviews the work of subordinate employees and assists with training and continuing education programs. Responsibilities include coding medical records utilizing ICD-10-CM and CPT-4 coding conventions, reviewing medical records to ensure specificity of diagnoses and procedures, and ensuring appropriate reimbursement for hospital and/or professional charges. The role involves abstracting information from medical records following established methods and procedures.
Duties include reviewing complex medical records needing research, coordinating and reviewing employee work, ensuring quality through audits, assisting with continuing education program development and presentation, consulting with and educating physicians on coding practices, communicating with nursing and ancillary personnel for accurate documentation, and maintaining strong knowledge of anatomy, physiology, medical terminology, disease processes, surgical techniques, medical record practices, standards, and regulations such as JCAHO, HCFA, and Medical Review of North Carolina.
Qualifications include advanced knowledge of ICD-10-CM and CPT-4 coding conventions, anatomy and physiology, medical terminology, DRG/APC reimbursement knowledge, familiarity with coding software, effective written and verbal communication skills, and data entry skills.
Education: High school diploma required.
Certifications: Must hold one of the following active certifications: RHIA, RHIT, CCS, CPC, or HCS-D. Experience requirements vary by certification: RHIA and RHIT require no prior experience; CCS requires one year of coding experience; CPC or HCS-D require two years of coding experience.
Duke University Health System is an equal opportunity employer committed to diversity, inclusion, and providing reasonable accommodations.
- High school diploma required
- Must hold one of the following active certifications: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Homecare Coding Specialist-Diagnosis (HCS-D)
- Experience requirements vary: RHIA and RHIT require no experience; CCS requires one year of coding experience; CPC or HCS-D require two years of coding experience
- Advanced knowledge of ICD-10-CM and CPT-4 coding conventions
- Strong understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques
- Familiarity with coding software and data entry skills
- Effective written and verbal communication skills
- Knowledge of DRG/APC reimbursement and medical record regulations such as JCAHO, HCFA, and Medical Review of North Carolina
Location
Durham, North Carolina, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago