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The Certified Coder translates medical documentation into accurate ICD-10 and CPT codes to ensure proper billing and reimbursement. They also review health records for quality, resolve claim edits, and query physicians to ensure documentation supports the assigned codes.
Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set.
Coding quality:
Queries physicians when necessary to ensure documentation supports the codes assigned.
Coding productivity:
Reviews records following feedback from payers, auditors and managers and makes corrections to coding, disposition and/or DRG assignment when indicated.
Accountability:
Minimum Requirements:
Preferred Qualifications:
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