Medical Coder

Role and responsibilities :

• Review of Medical records and assign/validate the appropriate clinical ICD-10-CM, CPT and HCPCS codes.
• Maintain accuracy, integrity and quality of coded patient data.
• Adhere to the company TAT for coding.
• Ensure code best suits the patient’s clinical condition according to coding regulations and patient’s recent

medical care, site of that care and procedures.

• Query providers as necessary to obtain accurate and complete documentation to facilitate optimal coding.
• Ensure coding is done at the highest appropriate level of specificity supported by the medical documentation and

monitor for opportunities to educate providers on documentation required for optimal specificity.

• Provide feedback and suggestions to providers regarding coding accuracy.
• HCC or ICD-10-CM coding experience is mandatory.
• CPT and HCPCS coding experience will be added advantage.
• Ensure compliance with and adhere strictly to all regulatory coding guidelines including:

a)ICD-10-CM Official Guidelines for Coding and Reporting
b)AHA Coding Clinics
c)CMS Medicare Part C instructions and requirements for diagnostic coding.
d)Following HIPAA and confidentiality of information.

Pre-requisites:

• Minimum 1 year of outpatient coding experience with ICD-10-CM.
• AAPC/AHIMA certification for coding with proficiency in ICD-10-CM.

Must-Have Experiences:

• Thorough knowledge of anatomy, physiology, pharmacology and medical terminology
• Abide by AHIMA and/or AAPC coding Code of Ethics
• Complies with Imagine policies, procedures
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

Desired Experience:

• 1.5+ years’ experience in HCC coding.
• Familiarity with Medicare Risk Adjustment.
• Experience working with providers for documentation improvement.
• E/M coding experience.