Clinical Coder

Appalachian Regional Healthcare•Hazard, KY

About The Position

The Clinical Coder reviews medical record documentation and assigns codes for reimbursement and statistical purposes. The role requires knowledge of coding systems, official coding guidance, reimbursement practices, and coding compliance. The Clinical Coder works with physicians to clarify unclear, illegible, or conflicting documentation and with the Business Office to resolve denied claims related to coding. The position may also involve coding audits and physician education, along with other related duties as assigned.

Requirements

At least two years of coding experience.
A bachelor’s degree, or an associate degree and successful completion of the AHIMA examination for Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), for inpatient or hospital outpatient coding.
Pass coding assessments administered by ARH before employment; assessments include coding directly from sample patient charts.
Individuals holding a CCA certification must obtain advanced certification as a CCS, CPC-H, CCS-P, or CPC, depending on coding specialty, within five years of hire.

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 clarification from physicians 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 denied claims due to coding issues.
Maintain working knowledge of the HBOC and 3M systems.
May perform coding audits for quality checks.
May provide physician education.
Perform other related duties as assigned.