Lead Medical Coder

2 weeks ago


Valhalla, United States NorthEast Provider Solutions Inc. Full time
Senior Coder Position at NorthEast Provider Solutions Inc.

Job Overview:

The Senior Coder is integral to managing appeals directed to insurance providers and ensuring precise coding of intricate medical records. This position demands proficiency in various coding systems, including ICD, CPT, and HCPCS, to systematically input coded data into an automated platform. Additionally, this role encompasses offering technical support and assuming a leadership role when required.

Key Responsibilities:

  • Resolve appeals related to insurance denials to facilitate prompt resolution and reimbursement.
  • Implement official coding standards to validate diagnoses and procedures.
  • Examine patterns in coding inaccuracies and document 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 regarding medical documentation.
  • Extract information from medical records for reporting needs.
  • Input data into automated databases.
  • Mentor and guide junior coders.

Qualifications/Requirements:

Experience:

A minimum of 6 years in medical records coding, with at least 4 years within the last 5 years, including 2 years focused on emergency room or trauma coding.

Education:

A High School diploma is required. Completion of 30 credits towards a health information management degree may substitute for up to 4 years of coding experience.

Licenses/Certifications:

Current certification as either a CCS, CCS-P, or CPC is mandatory.

Skills:

Extensive knowledge of coding regulations and code systems, familiarity with DRG and APC systems, proficiency in medical terminology, strong communication abilities, computer literacy, and fluency in English.


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