Medical Coder

Geisinger

3d • Remote

About The Position

Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures.

Requirements

• Level I Requirement: Specialty training / completion of billing/coding diploma
• Level II and above Requirements: One of the following certifications required at time of hire: Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) Certified Risk Adjustment Coder (CRC)- American Academy of Professional Coders (AAPC) Registered Health Information Technician (RHIT) - American Health Information Management Association
• High School Diploma or Equivalent (GED)- (Required)
• Minimum of 1 year-Related work experience (Required)
• Communication
• Computer Literacy
• Medical Records Management
• Medical Records Systems
• Teamwork
• Working Independently

Nice To Haves

• Graduate from Specialty Training Program- (Preferred)

Responsibilities

• Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient severity and comply with standard provider coding regulations.
• Carefully details review of documents such as laboratory findings, radiology reports, various scan reports, discharge summary, history and physical, consultations, orders, progress notes and other ancillary services treatment records needed to ensure all pertinent diagnoses and procedures are recorded.
• Translates all diagnostic and procedural phrases utilized by healthcare providers into coded form using procedure codes as required.
• Using the Encoder software program, determines the codes for all diagnoses and procedures.
• Determines their sequencing to legally maximize reimbursement.
• Assigns the appropriate DRG.
• Assigns codes based on hospital and professional coding guidelines, Coding Clinic directives, federal regulations, CCI coding initiatives, CPT Assistant or other standard coding guidelines
• Queries physicians as needed to clarify documentation within the patient’s record to facilitate complete and accurate coding.
• Reviews coding guidelines on an annual basis and makes recommendations for change to improve coding and data management.
• Communicates to Coding Quality and Professional Manager any new diagnoses, procedures, technologies, etc. documented within patient records to ensure that appropriate diagnosis and procedure codes are selected and incorporated into hospital and professional coding guidelines.
• Updates and corrects historical file data by completing and submitting claim action reports per the PHC4 quarterly report.
• Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.

Benefits

• We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.
• Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.
• We know that a diverse workforce with unique experiences and backgrounds makes our team stronger.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees