General Definition and Scope of Job:
The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
1. Organizes and reviews all daily encounter for completeness and accuracy. Tracks any missing encounter forms. Follows-up with site-specific staff on missing data or encounters identified;
2. Maintains knowledge of fee for service insurance payers, State , Federal and Manet discount programs to assure accurate billing procedures;
3. Consistently updates patient and insurance information to maximize accurate billing activities;
4. Participates in meetings and reviews of work progress with supervisor and department colleagues;
5. Interacts with departments to correct information as needed;
6. Demonstrates respect and confidentiality when processing information related to patient accounts and insurance information; and,
7. Edits claims for accuracy before submission to payer.
Minimum Skills, Experience and Educational Requirements:
1. High school education or equivalent experience;
2. 1+ years of professional coding experience;
3. Customer service
4. Basic computer and office suite skills;
5. Basic knowledge of coding guidelines; and,
6. Demonstrated ability to use resources to increase knowledge and problem solving skills
1. Previous facility based coding experience;
2. Coding certification to include the following: CPC, CCS, RHIA, and RHIT;
3. Previous managed care experience;
4. HCC/Risk coding experience; and,
5. Experience with HEDIS
Critical Demands of the Job:
1. Manage multiple requests and prioritize appropriately;
2. Ability to function in a faced paced setting with a variety of patients and staff;
3. Attention to details and prompt follow up;
4. Includes walking and standing for long periods of time, sitting for short periods of time, hand dexterity, clear hearing and speaking ability. Must be able to lift a maximum of 1/3 of their body weight;
5. Excellent organizational and interpersonal skills; and,
6. Must be responsive to multiple deadlines.
1. Works in well-lighted environment with comfortable surroundings;
2. Stressful at times due to competing demands, including attention to multiple patients and staff; and,
3. Will comply with all applicable laws, and will cooperate with the Manet Community Health Center compliance program rules and regulations.
May be required to work evenings, holidays or weekends, if department requires.
May be required to travel