Medical Records Coder III, Complex

About This Role

The Medical Records Coder III for complex cases is responsible for abstracting and in-depth analysis of medical documentation to assign appropriate procedural terminology and medical codes. This role ensures coding accuracy, resolves coding denials, and communicates documentation improvement opportunities to providers.

Responsibilities

• Review codes created by electronic charge capture and assign codes (ICD-10-CM, E/M, CPT, HCPCS and modifiers) through medical record documentation in accordance with universally recognized coding guidelines.
• Resolve coding denials and problems with claims having errors related to improper coding, providing feedback for correction and follow-up.
• Abstract data and review codes for accuracy, performing system edit checks and correcting errors as needed.
• Respond to coding information requests from various sources.
• Communicate documentation improvement opportunities and coding issues to providers, department, and/or designated leader for follow up and resolution.
• Consult with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete.

Requirements

• HS Diploma
• 2 years’ experience as Medical Coder
• Knowledge of ICD-10CM, CPT and HCPSC
• Working knowledge of medical terminology and anatomy

Qualifications

• HS Diploma required, Associate's degree in Health Information Technology or health related field preferred
• 2 years’ experience as Medical Coder required

Nice to Have

• Associate's degree in Health Information Technology or health related field
• Additional coding experience in area of assignment

Skills

* Required skills

Certifications