Job Specification:
- Review clinical documents, medical records, and physician notes to assign appropriate codes for diagnoses, procedures, and treatments based on established coding standards (ICD-10, CPT, HCPCS).
- Ensure codes used for billing are accurate and comply with insurance and government payer requirements.
- Collaborate with healthcare providers and other departments to clarify diagnoses and procedures, ensuring proper code assignment.
- Stay updated on coding guidelines, regulations, and changes in healthcare billing practices.
- Submit coded claims to the billing department or insurance companies for reimbursement.
- Conduct audits to ensure accurate coding and prevent compliance issues.
Requirements and skills:
- Certification in medical coding (e.g., CPC, CCS, or CCA) or equivalent training.
- Solid understanding of medical terminology, anatomy, physiology, and healthcare procedures.
- High attention to detail and accuracy in assigning codes.
- Familiarity with payer-specific guidelines, insurance rules, and government regulations (e.g., Medicare, Medicaid).
- Experience with electronic health records (EHR) and coding software.
- Ability to work independently and manage time effectively.
- Strong communication skills for collaborating with medical staff.
