Medical Coder

Job Summary

Apply diagnostic & procedural codes to individual patient individual health data for claims processing and ensure the claims are paid by payers. Review denials for coding lapses and suggest corrective and preventive actions. Review E / M charts and minor procedures, Lab and imaging performed during the visit.

Key Responsibilities & Duties

• Thorough understanding of the contents of medical record in order to identify information to support coding.
• Sound knowledge of anatomy & physiology of human body and diseases in order to understand etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and procedures to be coded.
• Should have an understanding of claims form and reimbursement process.
• Abstracts pertinent information from patient medical records. Assigns ICD-10-CM, CPT / HCPCS codes, and modifiers.
• Utilizing CCI edits, LCD policies, CPT and Clinical guidelines while assigning codes.
• Reviews denials for coding lapses and suggests coding changes for corrective and preventive (root cause) action by DHT (denial handling team) team.
• Actively reviews denials and research to create claims scrubber edit which will prevent specific coding denials permanently.

Qualification / Experience

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