Certified Medical Coder

Job Description

Job Description

Summary

Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and / or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements.

Key Responsibilities

Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application

Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission

Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system

Selects and accurately records all appropriate records and data on assigned chart abstraction projects

Ability to meet productivity and accuracy requirements

Performs other duties as assigned

Qualifications

High School Diploma or GED required

A certification in one of the following is required :

Certified Professional Coder (CPC)

Certified Risk Adjustment Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

Registered Health Information Administrator (RHIA)

Minimum of three (3) years HCC experience performing concurrent and retrospective risk adjustment chart reviews required

Current AAPC or AHIMA credential required

Risk Adjustment / HCC knowledge required

Managed Care experience preferred