Certified Coder

The Certified Coder plays a key role in converting diagnoses and treatment procedures into ICD-10, CPT, and HCPCS codes. This role reviews and accurately codes office and hospital procedures for reimbursement.

Essential Functions

• Account for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
• Research and analyze data needs for reimbursement.
• Analyze medical records and identify documentation deficiencies.
• Serve as a resource and subject matter expert to other coding staff.
• Review and verify that documentation supports diagnoses, procedures, and treatment results.
• Identify diagnostic and procedural information.
• Audit clinical documentation and coded data to validate that documentation supports services rendered for reimbursement and reporting purposes.
• Assign codes for reimbursement, research, and compliance with regulatory requirements using guidelines.
• Follow coding conventions and serve as a coding consultant to care providers.
• Identify discrepancies, potential quality of care issues, and billing issues.
• Research, analyze, recommend, and facilitate plans of action to correct discrepancies and prevent future coding errors.
• Identify reportable elements, complications, and other procedures.
• Assist the lead or supervisor in orienting, training, and mentoring staff.
• Maintain patient and employee privacy and confidentiality.
• Maintain coding credentials and ongoing coding education.
• Maintain regular and predictable attendance.
• Support the Medical Center's mission, vision, and philosophy positively.
• Handle special projects as requested.