Job Description

We are seeking a Senior Medical Coder to become an integral part of our team! You will conduct audits and establish compliance procedures to ensure coding accuracy and efficiency.

Responsibilities:

• Communicate with physicians and insurance companies to diagnose claim and coding issues.
• Perform audits to analyze coding efficiency and accuracy rates to improve upon.
• Review and analyze medical records to identify diagnoses, procedures, and services provided.
• Assign appropriate ICD-10 codes to reflect the diagnoses and procedures documented in the medical records.
• Ensure coding accuracy and compliance with coding guidelines, regulations, and payer requirements.
• Problem solve claim edits and support the denial process as requested.
• Maintain coding quality accuracy rates and improve as needed.
• Identify documentation issues that may impact coding accuracy, create actions plans to solve identified issues.
• Clearly communicate (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
• Maintain the required level of knowledge related to coding and compliance as necessary.
• Develop training initiatives and strategies to improve organizational performance.
• Assist in new hire orientation process and other areas as needed for training.
• Track and create reports on training outcomes for further training content development.

Requirements:

• Must possess knowledge of third-party reimbursement regulations and billing practices.
• CPC certification is required.
• Must have knowledge of AMA, CMS, and CPT coding guidelines.
• Knowledge of ICD-10, medical terminology.
• 5-7 years of medical coding experience required.
• Proficiency in knowledge of CCI edits and LCDs and be able to accurately apply regulation knowledge to coding situations.

Disclaimer:

• The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.
• The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
• We are an Equal Opportunity Employer committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

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