Professional Medical Coder I

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Professional Coder I is responsible for a complete review of the medical record documentation and performs a variety of coding related activities for 1 or more specialties. Work may include, but are not limited to: charge review,coding review, prioritizing workload, resolving edits, researching denials, interacting with clinicians verbally and /or in writing, and performing other coding related tasks.

EEO/AA/Disability/Veteran

Responsibilities

• Reviews medical record documentation to determine appropriate ICD-10-CM codes for work identified for a coding review in accordance with official coding guidelines.
• Reviews medical record documentation and reviews clinician charging to accurately select and/or validate the appropriate CPT codes and modifiers in accordance with official coding guidelines. This includes resolving coding edits, as applicable.
• Maintains a minimum of 95% overall coding quality score in work that qualifies for a coding review in diagnostic, procedural, modifier code selection and other applicable fields.
• Maintains the productivity expectations as defined by the department for the coding service line.
• Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions, and actively participates in learning circles
• Reviews specialty specific denials and consults research needed to resolve.
• Completes other coding related roles and responsibilities as assigned by the department manager.

QualificationsEDUCATION

• Bachelors degree preferred. Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process.

EXPERIENCE

• Requires a minimum of 2 years of professional coding experience.

LICENSURE

• CPC or CCS-P credential required or another professional coding designation through the Academy of Professional Coders (AAPC). CPC-As are not acceptable in this level of position.

SPECIAL SKILLS

• Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM, and CPT coding with the ability to acclimate and apply knowledge in a fast-paced virtual coding environment.
• Knowledge of professional E/M leveling preferred.
• Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills.
• Must be able to perform functions independently and under limited supervision.

YNHHS Requisition ID:

190217

• Reviews medical record documentation to determine appropriate ICD-10-CM codes for work identified for a coding review in accordance with official coding guidelines.
• Reviews medical record documentation and reviews clinician charging to accurately select and/or validate the appropriate CPT codes and modifiers in accordance with official coding guidelines. This includes resolving coding edits, as applicable.
• Maintains a minimum of 95% overall coding quality score in work that qualifies for a coding review in diagnostic, procedural, modifier code selection and other applicable fields.
• Maintains the productivity expectations as defined by the department for the coding service line.
• Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions, and actively participates in learning circles
• Reviews specialty specific denials and consults research needed to resolve.
• Completes other coding related roles and responsibilities as assigned by the department manager.

EDUCATION

• Bachelors degree preferred. Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process.

EXPERIENCE

• Requires a minimum of 2 years of professional coding experience.

LICENSURE

• CPC or CCS-P credential required or another professional coding designation through the Academy of Professional Coders (AAPC). CPC-As are not acceptable in this level of position.

SPECIAL SKILLS

• Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM, and CPT coding with the ability to acclimate and apply knowledge in a fast-paced virtual coding environment.
• Knowledge of professional E/M leveling preferred.
• Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills.
• Must be able to perform functions independently and under limited supervision.