Medical Coder/ IPDRG

Job Summary

• Reviews and evaluates hospital outpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes. Perform coding and/or code validation across multiple entities. Applies all appropriate coding guidelines and criteria for code selections.Adheres to Company and HSC Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedure.
• Supervisor: Coding Manager
• Supervises: None

Duties (included but are not limited to):

> Using ICD-10-CM and/or HCPCS/CPT, assigns, validates, and/or edits codes for the following patient types:> Emergency room (ED)> Recurring (RCR) excluding Wound Care and Cardiac Cath, and

> Clinical (CLI) records

> Provider Office Visit (POV)

> Assigns, validates, and/or edits the ED E/M levels, and enters and/or validates charges for ED,OB ED and/or observation (OBV) infusions and/or injections.

> Assigns, validates, and/or edits procedure categories and modifiers.

> Maintains or exceeds established productivity standards.

> Maintains or exceeds established accuracy standards.

> Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.> Meets all educational requirements as stated in current Company and HSC policies.

> Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes. 2 Job Description:

> Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes.

> Initiates, validates, and/or edits physician queries in compliance with Company and HSC policy when appropriate

> As needed, may periodically be asked to perform Coding Account Resolution Specialist I (CARSI) duties.

> Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”.

> Other duties as assigned.

experience10