This role is responsible for abstracting, coding, sequencing, and interpreting clinical information from various medical records including inpatient, outpatient, emergency department, pro fee, and clinical records. The coder will assign principal diagnoses, secondary diagnoses, principal procedures, and secondary procedures, ensuring accurate sequencing. They will utilize technical coding principles and DRG/APC reimbursement expertise to assign appropriate codes, abstracting and coding pertinent medical data into multiple software programs and/or encoders, following official coding guidelines. The position requires maintaining compliance with external regulatory and accreditation requirements, as well as State and Federal regulations. The coder will extract pertinent data from patient health records, determine appropriate coding for reports and billing documents, and identify codes for reporting medical services and physician-performed procedures, entering codes into various computer systems. Responsibilities also include tracking and documenting productivity in specified systems to meet client-defined levels and maintaining a 95% quality rating. All duties must be performed in compliance with Company policies and procedures, including those related to HIPAA and compliance.
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Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed