The PFS Medical Coder is responsible for translating healthcare diagnoses, procedures, services, and equipment into standard medical codes. This role assigns and verifies accurate codes, ensures proper application during the billing process, and supports claim creation for insurance reimbursement.
The coder works closely with hospital, clinic, and physician office teams to provide professional healthcare services to the communities served.
Requirements & Qualifications
Duties
- Assign diagnosis and procedure codes using ICD-10, CPT, and HCPCS codes.
- Ensure codes are accurate and sequenced correctly according to government and insurance regulations.
- Review documentation for completeness and follow up with providers when information is unclear or insufficient.
- Keep codes current and active.
- Follow up on denials and rejections in a timely manner.
- Respond to coding questions and clarify issues for colleagues.
- Communicate appropriately with clinics and escalate non-routine issues to management.
- Re-code and reprocess denied or rejected claims as needed.
- Monitor diagnoses and CPT codes for accuracy before billing.
Qualifications
- Current, unexpired CPC or CCS certification from AAPC, NHA, or AHIMA.
- At least 2 years of medical coding experience in a multi-specialty office or hospital system.
- Knowledge of medical terminology.
- Familiarity with legal and ethical compliance in medical coding.
- Experience with medical coding policies and procedures.
- Analytical skills to evaluate medical charts and records.
- Strong communication skills.
- Ability to use a PC keyboard, copier, printer, and other office equipment.
Location
Illinois, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 weeks ago
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