Medical Coder II - HIM Hospital Coding

Performs technical and administrative work reviewing, abstracting, and assigning accepted medical CPT, HCPCS, and ICD-10 codes for professional services. Duties are performed in compliance with third-party, state, and federal regulations according to standardized procedures. The employee reports to an administrative superior but independently handles assigned tasks.

Responsibilities

• Assign ICD-10-CM diagnosis codes accurately and productively.
• Assign diagnosis codes for chronic conditions documented that may impact HCCs or expected mortality.
• Assign HCPCS and CPT codes accurately and productively.
• Group codes and completed product into payment groups and analyze information for optimal reimbursement.
• Review NCD, LCD, CCI, and other coding edits and apply changes or modifiers appropriately.
• Recognize and apply medical necessity requirements and resolve edits during code assignment.
• Ensure compliance with coding, billing, and data collection regulations and procedures.
• Provide coding guidance to physicians and other healthcare staff regarding current practices and regulatory changes.
• Review, analyze, and abstract physician and other documentation for diagnoses, procedures, and services provided.
• Obtain missing information and clarify existing information as needed.
• Accept feedback from auditors to reduce future errors.
• Research appropriate databases to validate information.
• Use software such as Epic, Optum CAC, and MS Office to compile and validate medical information.