Certified Medical Coder
About The Position
The Certified Medical Coder reviews medical record documentation, including procedure reports, and assigns appropriate CPT and ICD-10 codes. The role is responsible for timely charge submissions and/or data entry of coded services. The coder produces coded abstracts for physician billing, submits coded services for billing or claim submission, reviews inpatient data and reconciles billable services, and resolves coding-related claim edits and errors. The position requires maintaining knowledge of coding and documentation requirements for physician services under CPT, ICD-10, CMS, and CHOP Compliance standards.
Requirements
- High school diploma or GED.
- At least one year of coding experience.
- At least one of the following certifications upon hire: CPC, CPC-A, CPC-H, CCS, or CCS-P.
- Advanced knowledge of specialty coding.
- Advanced knowledge of ICD-10, third-party procedures, and requirements regarding benefit structures, insurance verification, referrals, and authorizations.
- Advanced knowledge of general financial counseling and the revenue cycle.
- Familiarity with electronic health records (EHR).
- Intermediate proficiency with Microsoft Office, including Word and Excel.
- Excellent verbal and written communication skills.
- Excellent interpersonal skills.
- Strong critical-thinking and problem-solving skills.
- Strong analytical skills.
- Ability to maintain confidentiality and professionalism.
- Ability to work independently with minimal supervision.
- Ability to gather and analyze data and make recommendations or decisions based on it.
- Ability to convey complex or technical information in an easy-to-understand manner.
Nice To Haves
- Associate's degree.
- At least two years of coding experience.
Responsibilities
- Systematically review and analyze patient medical records to identify appropriate diagnoses and procedures and produce coded abstracts for physician billing.
- Submit coded services for billing and/or enter coded services for claim submission in accordance with departmental productivity and accuracy standards.
- Review inpatient data and reconcile billable services, including reviewing system processing, escalating issues, and communicating errors, omissions, and clinical documentation insufficiencies in a timely manner.
- Review and resolve coding-related edits and errors that affect claim submission.
- Maintain thorough knowledge of CPT, ICD-10, CMS, and CHOP Compliance coding and documentation requirements for physician services.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
