01Key Responsibilities
1. Medical Coding:
- Review clinical documents, including medical records, physician notes, and diagnostic reports, to assign accurate ICD-10, CPT, and HCPCS codes for diagnoses, treatments, and procedures.
- Ensure accurate coding of all diagnoses, treatments, and procedures based on patient records to support billing and insurance claims.
- Work with physicians, clinical staff, and other healthcare professionals to resolve any discrepancies or ambiguities in the medical records for coding accuracy.
- Ensure all codes comply with the latest industry guidelines, payer requirements, and regulatory standards (e.g., HIPAA).
1. Compliance & Accuracy:
- Adhere to coding guidelines and ensure compliance with all relevant healthcare regulations and payer-specific requirements.
- Follow best practices for coding to minimize errors and ensure coding accuracy.
- Perform regular reviews of coding work to ensure that all records are coded accurately, completely, and in compliance with the highest quality standards.
- Maintain a deep understanding of industry changes, coding updates, and new regulations to ensure ongoing compliance.
1. Coding Audits & Quality Checks:
- Participate in internal coding audits to assess and improve coding accuracy.
- Correct any coding errors identified during audits and work with supervisors or team leads to implement corrective measures.
- Follow up on coding discrepancies, ensuring timely resolution and re-submission of corrected claims.
1. Collaboration & Communication:
- Collaborate with the Quality Assurance (QA) team, physicians, and clinical staff to clarify medical record documentation, and resolve any queries related to coding.
- Maintain communication with the billing department to ensure accurate claim submission and resolution of any issues with insurance payers.
- Address and respond to coding-related queries from team leads or management promptly.
1. Continuous Learning & Development:
- Stay up to date with new medical coding updates, industry standards, and regulatory changes to ensure the highest level of coding accuracy.
- Participate in ongoing training and certification programs to enhance knowledge and improve coding skills.
- Share knowledge and assist fellow coders with complex cases and coding challenges.
1. Documentation & Record Maintenance:
- Accurately document coding assignments, changes, and clarifications in medical records.
- Maintain organized records of coding and billing data in compliance with company standards and legal requirements.
1. Team Support:
- Collaborate with team members to ensure that all coding tasks are completed within the designated timelines and in line with quality standards.
- Assist in training new coders and sharing best practices to improve team efficiency and accuracy.
Qualifications:
- Education:
- Bachelor's degree in Life Sciences, Healthcare Administration, or a related field.
- Certification in Medical Coding (e.g., CPC, CCS, or equivalent) is required.
- Additional certifications in specialized coding areas (e.g., CPC-H, CPC-P) are an advantage.
- Experience:
- 2+ years of experience in HCC medical coding
- Knowledge of medical coding systems (ICD-10, CPT, HCPCS).
- Familiarity with medical terminology, anatomy, and physiology.
- Skills:
- Strong attention to detail, with the ability to review complex medical documentation and accurately assign codes.
- Excellent knowledge of coding practices, standards, and payer requirements.
- Proficiency in coding software and tools, as well as MS Office (Excel, Word).
- Strong communication skills to interact with physicians, clinical staff, and other team members.
- Ability to handle high volumes of work and meet deadlines in a fast-paced workplace.
Personal Attributes:
- High level of integrity and commitment to maintaining confidentiality.
- Strong organizational and time-management skills.
- Ability to work independently and as part of a team.
- Proactive problem-solving attitude with attention to detail.
- Continuous learner, staying updated on industry changes and best practices. .
