Certified Medical Coder

Description:

Primary Responsibilities:

1. Analyze physician documentation and clinical reports to accurately assign codes for diagnoses, procedures, and services.

2. Use standard coding systems (CPT, ICD-10-CM, HCPCS Level II, III) translate medical records into billable codes.

3.Ensure that codes are according to AMA, CMS guidelines and payer-specific rules (Medicare, Medicaid, commercial insurers).

4. Comply with HIPAA regulations and company policies.

5. Collaborate with billers to ensure correct charges are submitted.

6. Assist in correcting claim errors related to coding.

7. Communicate with providers to clarify ambiguous or missing information in patient records.

8. Participate in regular audits to ensure accuracy and prevent over- or under-coding.

9. Flag and correct discrepancies.

10. Review denial reasons related to coding and suggest corrections or re-submissions.

Specialty Expertise:

Good to have with multiple specialties such as cardiology, Internal/Family medicine, Gastro etc.

Expereince: 2 to 4 years.