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Lead Medical Coder
2 months ago
Job Overview:
The Senior Coder is essential in managing appeals directed at insurance providers and ensuring precise coding of intricate medical records. This position requires the application of various coding systems, including ICD, CPT, and HCPCS, to input coded data into an automated platform. Additionally, this role encompasses offering technical support and assuming a leadership role when necessary.
Key Responsibilities:
- Handle appeals regarding insurance denials to ensure prompt resolution and reimbursement.
- Implement official coding standards to validate diagnoses and procedures.
- Examine patterns in coding inaccuracies and communicate findings.
- Engage in the review process of medical records.
- Assign precise codes to diagnoses and procedures based on physician documentation.
- Guarantee appropriate ranking of diagnoses for correct DRG assignment.
- Input code numbers and descriptions into an automated system.
- Maintain and update logs of appeals.
- Provide information and address inquiries related to medical documentation.
- Extract information from medical records for reporting purposes.
- Input data into automated databases.
- Mentor and guide junior coders.
Qualifications and Requirements:
Experience:
A minimum of 6 years in medical records coding, with at least 4 years within the last 5 years, including 2 years in emergency room or trauma coding.
Education:
A High School diploma is required. Completion of 30 credits towards a health information management degree may replace up to 4 years of coding experience.
Licenses and Certifications:
Current certification as either a CCS, CCS-P, or CPC is mandatory.
Skills:
Comprehensive understanding of coding guidelines and systems, familiarity with DRG and APC systems, proficiency in medical terminology, strong communication abilities, computer literacy, and fluency in English.
