Coder, CPC

• Reviews/audits and interprets medical record documentation to identify pertinent diagnosis/procedure and apply correct ICD
  10, CPT-4, and HCPC's codes in accordance with government and insurance regulations.
• Demonstrates appropriate utilization of coding software and coding reference material.
• Follow up with providers on any documentation that is insufficient, missing, or unclear.
• Assists providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders.
• Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines.
• Reviews and resolves suspended charges due to claim edits or payor rejections related to coding.
• Reviews, corrects and appeals coding-related denials trends and shares with leadership, and team members to facilitate root cause analysis and continuous process improvement.
• Corrects and/or appeals denied claims due to coding errors
• Other duties as assigned

Requirements

• Minimum 3 years coding/medical billing experience
• Professional coder certification with credentialing from AHIMA and/or AAPC, must be maintained annually
• ICD
  10 certified and/or extensive work experience

Core Competencies

Expertise in medical coding and billing, including proficiency in ICD
10, CPT-4, and HCPC's coding standards. Strong ability to analyze medical documentation, resolve coding-related denials, and provide education to healthcare providers on coding guidelines.

Highest-signal resume keywords

• ICD
  10 Coding
• CPT-4 Coding
• HCPC's Coding
• Professional Coder Certification
• Medical Billing Experience

ATS Optimization Keywords

Hard Skills

• Medical Record Documentation Review
• Coding Software Utilization
• Claim Denial Resolution
• Coding Guidelines Interpretation
• Root Cause Analysis

Soft Skills

• Communication
• Feedback Provision
• Education Facilitation

Certifications & Qualifications

• AHIMA Certification
• AAPC Certification
• ICD
  10 Certification

Industry Keywords

• Medicare Guidelines
• National Correct Coding Initiative
• Payer-Specific Guidelines
• Coding Documentation Trends