Under the direct supervision of the Assistant Director of Revenue Cycle Management or Coding Supervisor, the Medical Group Coder improves documentation, data quality, and revenue cycle operations. The coder reviews and analyzes medical records to accurately assign HCPCS service codes and ICD-10-CM diagnosis codes for professional services provided in hospital-based primary care, psychiatric, and other non-inpatient surgical settings, including office, outpatient, and inpatient settings.
Responsibilities include:
- Assign HCPCS service codes, including HCPCS, CPT, CPTII, and CPTIII, based on medical record review and applicable guidelines.
- Assign modifiers and review medical necessity, CCI edits, and other coding edits.
- Assign ICD-10-CM diagnosis codes using insurance, hospital-based, and office-based guidelines.
- Submit queries to providers, clinical staff, and managers for incomplete, unclear, or inconsistent documentation.
- Re-submit queries as needed to ensure timely resolution.
- Provide education to providers and clinical staff on documentation and workflow opportunities.
- Assist departments with diagnostic and procedural coding.
- Assist the Business Office with insurance denials.
- Perform other duties as required.
Requirements & Qualifications
- Knowledge of EMR, electronic coding resources, Microsoft Office, and email systems.
- Professional coding coursework preferred.
- Knowledge of Epic, 3M ICD-10-CM and CPT software, and Vitalware preferred.
- Knowledge of CMS Teaching Physician Guidelines for Residents and Medical Students preferred.
- 2 years of hospital-based professional coding experience preferred.
- CPC, CCS-P, or related AHIMA or AAPC professional certification required.
Location
New York, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago
Similar Jobs
Browse More Jobs