Job Description

Empower. Unite. Care.

We are committed to empowering New Yorkers by uniting communities through care. We believe that Healthcare is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

Position Overview

The Inpatient/Outpatient Coder is responsible for conducting coding audits and education for providers with greatest opportunity for improvement. This individual will ensure medical diagnosis and procedure codes submitted on provider claims are accurate. In addition, this person will review medical records for: physician documentation, clinical evidence that supports the diagnoses, medical necessity of procedures, appropriate setting of care and accurate use of CMS coding guidelines.

Job Description
● Identifies trends and inconsistencies in provider documentation and coding practices.
● Audits and reviews medical records to determine if the medical record is complete, accurate,and in support of individual patient risk adjustment score accuracy.
● Develops curriculum to improve provider coding practices.
● Educates providers and their practice staff in coding guidelines.
● Works in collaboration with other departments, develop plans and materials that support education and system changes to ensure proper coding is a standard practice for all providers.
● Participates in the review and analysis of summary data. Assist with data collection and report generation.
● Maintains the confidentiality and security of sensitive information and files.

Requirements

● Associate degree required.
● 3-5 years healthcare experience in a physician group practice or other ambulatory care setting preferred.
● 1+ years of medical coding experience with demonstrated sustained coding quality.
● In-depth knowledge of coding/classification systems appropriate for inpatient, outpatient, APR-DRG/MSDRG and APC/APG prospective payment systems
● Demonstrates advanced knowledge of CPT/HCPS/Revenue Code procedure coding, ICD-9/ICD-10 coding principles and practices.
● Ability to research authoritative citations related to coding, compliance, and additional reporting requirements.
● Demonstrates overall knowledge of claims processing for various insurance both private and government


Licensure and/or Certification Required

● Certification as a professional coder (CPC) 

Job Tags

Similar Jobs