REPORTS TO: Director of Revenue Cycle

General Definition and Scope of Job:

The Medical Coder provides coding and auditing services directly to providers. This includes the analysis and translation of documentation to ICD-10, CPT, and HCPCS codes.

Core Responsibilities:

  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:

Required Qualifications:

  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

Preferred Qualifications:

  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 fast paced setting with a variety of patients and staff;
  3. Attention to detail 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.

Working Conditions:

  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.

Required Availability:

May be required to work evenings, holidays or weekends, if department requires.
May be required to travel