Clinical Coder at St Vincent’s Private Hospital analyzing patient records and assigning ICD clinical codes for accurate care classification. Participating in ongoing training and audits to maintain coding quality.
About the role
- Medical Records Coder reviewing coding accuracy per guidelines and resolving insurance coding denials. Ensuring accurate reimbursement and collaborating with internal and external sources for documentation clarity.
Responsibilities
- Reviews codes for accuracy in accordance with coding rules and policies
- Responsible for system edit reviews and follows up on insurance coding denials for resolution
- Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation
- Completes system edit reviews to make corrections before transmittal
- Troubleshoots problems that prevent claims from being released
- Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem
- Provides feedback for correction and follow-up
- May abstract data and review codes for accuracy
- Ensures accurate reimbursement based on guidelines and/or abstraction of provider documentation
- Responds to coding information requests and inquiries from various sources
- Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete
Requirements
- High School diploma or equivalent
- 1 year Medical Coder experience required
- Associate's degree preferred
- Knowledge of ICD-10CM, CPT and HCPSC required
- Working knowledge of medical terminology and anatomy required
- American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred
- Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute preferred
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
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