Clinical Coder

Appalachian Regional Healthcare, Inc.•Harlan, KY

About The Position

The Clinical Coder reviews medical record documentation and assigns codes for reimbursement and statistical purposes. The role requires working knowledge of coding fundamentals, coding guidelines, reimbursement systems, and coding compliance. The coder assigns codes based on documentation, seeks clarification from physicians when documentation is unclear, illegible, or conflicting, and works with the Business Office to resolve denied claims related to coding. The position may also include coding audits and physician education.

Requirements

Minimum of two years of coding experience.
Bachelor’s degree, or an associate degree with successful completion of the AHIMA-approved RHIA or RHIT examination, for inpatient or hospital outpatient coding.
Applicable coding certification for the coding specialty: CCS, RHIA, RHIT, or CPC-H for inpatient or hospital outpatient coding; CCS-P or CPC for physician services coding; or CCA for professionals new to the coding field.
CCA holders must obtain advanced certification as a CCS, CPC-H, CCS-P, or CPC, depending on coding specialty, within five years of hire.
Successfully complete and pass ARH coding assessments before employment; assessments include coding directly from sample patient charts.

Responsibilities

Maintain working knowledge of ICD-9-CM coding for inpatient, outpatient, and/or physician services; HCPCS CPT-4 coding for surgical procedures; and/or HCPCS Evaluation and Management coding for physician services.
Maintain working knowledge of the Official Guidelines for Coding and Reporting, the American Hospital Association’s Coding Clinics, and/or the American Medical Association’s CPT Assistant.
Maintain working knowledge of reimbursement as it relates to coding, including government prospective payment systems and third-party medical billing requirements.
Assign codes based on medical record documentation and seek physician clarification when documentation is unclear, illegible, or conflicting.
Achieve and maintain a high level of accuracy and productivity in coded claims.
Maintain working knowledge of coding compliance.
Work with the Business Office to reconcile claims denied due to coding issues.
Maintain working knowledge of the HBOC and 3M systems.
Perform some coding audits for quality checks, as needed.
Provide some physician education, as needed.
Perform other related duties as assigned.