Medical Group Coder I

Mohawk Valley Health System • City of Utica, NY

3d • $23 - $34

About The Position

Under the direct supervision of the Assistant Director of Revenue Cycle Management or Coding Supervisor, the Medical Group Coder improves documentation, data quality, and revenue cycle operations. The coder reviews and analyzes medical records to accurately select HCPCS service codes (HCPCS, CPT, CPTII, CPTIII) and ICD-10-CM codes for professional services provided by hospital-based primary care, psychiatric, and other non-inpatient surgical providers. This includes services in office or other outpatient settings and inpatient settings.

The role also supports coding education and workflow improvements, assists departments with diagnostic and procedural coding, and helps the Business Office address insurance denials. Other duties may be assigned as required.

Requirements

• Knowledge of EMR, electronic coding resources, Microsoft Office, and email systems.
• CPC, CCS-P, or related AHIMA or AAPC professional certification.

Nice To Haves

• Completed professional coding coursework.
• Knowledge of Epic, 3M ICD-10-CM and CPT software, Vitalware, Microsoft Office, and email systems.
• Knowledge of CMS Teaching Physician Guidelines for Residents and Medical Students.
• Two years of hospital-based professional coding experience.
• CPC, CCS-P, or related AHIMA or AAPC professional certification.

Responsibilities

• Assign applicable HCPCS service codes (HCPCS, CPT, CPTII, CPTIII) based on medical record review and analysis, following CMS, CPT, insurance company, hospital-based, and office-based guidelines.
• Assign applicable modifiers and review medical necessity, CCI, and other internal and external coding edits.
• Assign applicable ICD-10-CM diagnosis codes according to ICD-10-CM, insurance company, hospital-based, and office-based guidelines.
• Submit and, as necessary, resubmit queries to providers, clinical staff, and managers regarding incomplete, unclear, or inconsistent documentation to ensure timely resolution.
• Educate providers and clinical staff about documentation and workflow opportunities.
• Assist departments with diagnostic and procedural coding.
• Assist the Business Office with insurance denials.
• Perform other duties as required.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed