Pro-Fee Coder

Position Summary

Conducts necessary audits of medical record to verify that providers have appropriately documented chronic medical conditions, then code these in ICD-10 to capture HCCs and improve the organization’s Medicare Risk Adjustments score. Evaluate medical record documentation (outpatient/inpatient) from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past. This process involves a very strong understanding of medical coding and excellent communication skills.

• Abstracts pertinent information from patient medical records, assigning appropriate ICD-10-CM codes, creating HCC assignments as applicable.
• Check chart assignments every day and report accurately all hours worked on a weekly basis.
• Remain current on medical coding guidelines and reimbursement reporting requirements.
• Queries when documentation in record is inadequate, ambiguous or otherwise unclear for medical coding purposes.
• Provide Education – Provide detailed summary to make adjustments to correct improperly paid claims and document the correct coding to be utilized.
• Prepare management summary report of audit findings.
• Comply with the Standards of Ethical Coding as set forth by the AHIMA (American Health Information Management Association) and adhere to official coding guidelines.
• Comply with HIPAA laws and regulations.

7:30 am - 4:00 pm (24 hrs/week) On-site work for training, eventually able to work remotely.

Two-year health information technician. The physician coder must possess a thorough working knowledge of current nomenclature coding systems, i.e. ICD-10 and CPT.

A minimum of three to five years of experience in a clinical setting.

RHIT, CCS, CCS‑P, and/ or CPC are required.