Coder Job Description

Coder Job Description

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Coder provides CPT/ICD, billing expertise to the practice in all areas of billing; directs changes in billing practice in response to billing regulation and reimbursement.

Coder Duties & Responsibilities

To write an effective coder job description, begin by listing detailed duties, responsibilities and expectations. We have included coder job description templates that you can modify and use.

Sample responsibilities for this position include:

Code for CPT and ICD-9 - both diagnosis and procedural codes
Review medical documentation (both preliminary and final) of ASOBGYN EHR to ensure CPT and ICD-9 coding accuracy and compliance
Abstracts CPT-4, HCPCS II, and ICD-9-CM from medical records
Charge entry into billing system in a timely manner
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-9/ICDD-10 materials, Federal Register, and other pertinent materials
Assist with establishing compliance policies in accordance with the Company's compliance strategies and priorities, applicable laws, regulations, and industry codes
Monitor and, as necessary, coordinate compliance activities to remain abreast of the status of all compliance activities
Provide reports on all findings upon completion audits
Assist in the development of site and provider specific training, corrective action plans based on audit results
Track and trend audit results

Coder Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Coder

List any licenses or certifications required by the position: CCS, AHIMA, RHIT, CPC, RHIA, AAPC, CHC, CIC, COC, CCA

Education for Coder

Typically a job would require a certain level of education.

Employers hiring for the coder job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Health Information Technology, Education, Medical, Associates, Health Information Management, Health, Business, Healthcare, Medical Terminology, Computer

Skills for Coder

Desired skills for coder include:

Medical terminology
Anatomy and physiology
Anatomy
Pharmacology
Physiology
Pathophysiology
CPT
Disease processes
Human anatomy and physiology
Billing

Desired experience for coder includes:

Review monthly list of refunds provided by Compliance Team to verify that a refund has been appropriately processed
Work closely with the Regulatory Associates to manage outside auditors
Assist with external audits and reviews due to coding and medical necessity by analyzing risk potential, assisting in medical record collection/submission, and appealing findings
Travel outside of the office is required and a valid driver’s license is required
Certified Medical Coder with CPC (AAPC certified) and high degree of competency in this area
Prior coding experience in a medical office environment, 1-2 years preferred

Coder Examples

1

Coder Job Description

Job Description Example
Our company is looking for a coder. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for coder
  • Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-9/ICD-10 materials, the Federal Register, and other pertinent materials
  • Available to assist and direct the practice and coding operations team or other appropriate staff in surgical documentation, billing, coding, and reimbursement issues
  • Performs data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT, and HCPCS Level II code and modifier assignments, APC group appropriateness, missed secondary diagnoses and/or procedures, and ensure
  • Produce reports on a monthly basis to identify procedures that are denied for medical necessity or are non-covered services
  • Provide educational training to physicians, physician assistants, technicians and staff on coding and compliance issues
  • Monitor reimbursement of selected procedures on a continuous basis and identifies changes in reimbursement patterns
  • Monitor payment denials, reductions and rejections to determine operational or coding problems
  • Abstracting diagnosis and service
  • Supporting the coding and charging capture needs of the hospital
  • Monitoring unbilled surgical / procedural services
Qualifications for coder
  • Certified Medical Coder with high degree of competence in this area
  • Strong knowledge of Microsoft Office products (Word, Excel, Access)
  • Knowledge of coding for all service types – hospital, provider and ancillary
  • Certified Medical Coder with CCS
  • Certificate of ICD-10-CM Proficiency
  • Knowledge and experience in health care environment
2

Coder Job Description

Job Description Example
Our innovative and growing company is looking for a coder. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for coder
  • Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines
  • Perform coding and related duties using established Steward Coding Service's policies in an accurate and timely manner
  • Demonstrate a commitment to integrating coding compliance standards into daily coding practices
  • Maintain adequate knowledge of coding, compliance and reimbursement procedures
  • Function as a resource to Steward internal units and external customers
  • Provide daily direction and communication to Coding staff to ensure proper coding is efficient and effective for the data entry department
  • Interface with Physicians, Nurse Practitioners, and other Managers to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices
  • Establishes and implements short- and long-range goals that support company and site standards, objectives, policies, strategic directives and operating procedures
  • Researches, analyzes, and responds to inquires regarding compliance, inappropriate coding, denials, and billable services
  • Insure employees have appropriate training and other resources to perform their jobs develop additional skills
Qualifications for coder
  • This position can at times require extensive travel, 50% in the Central, Central East and Northeast Florida areas
  • Certified Medical Coder with either CPC, CCA or CCS through AHIMA or AAPC
  • Strong knowledge of Microsoft Office XP products (Word and Excel)
  • ICD 9 and ICD-10 certified
  • Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately
  • Analyzes and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees
3

Coder Job Description

Job Description Example
Our company is searching for experienced candidates for the position of coder. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for coder
  • Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT, ICD-10 and ICD-9 coding to these services
  • Extracts pertinent highly complex information from clinical notes, operative notes, radiology reports, laboratory reports, specialty forms, using ICD-9-CM/ ICD-10-CM/PCS codes, POA indicators and PSI indicators
  • Maintains knowledge and skills via written coding resources, clinical information, videos
  • Utilizes information on diagnostic reports
  • Receives and reviews charge documents from the clinic and/or hospital
  • Works in conjunction with A/R team on follow up and resolution of coding related denials and rejections
  • Attend assigned meetings or functions as specified by the Coding Manager
  • Reviews and codes clinical notes for physician documentation
  • Coordinates and reconciles encounters to ensure complete charge capture
  • Work in conjunction with A/R team on follow up and resolution of coding related denials and rejections, including recommendation of new/updated coding edits
Qualifications for coder
  • Knowledge of insurance processes and reconciliation regarding the denial process
  • Minimum of 1 year of experience or successful completion of an approved coding education program
  • Experience with ICD-10, ICD-9-CM and CPT4 and HCPCS coding systems, UHDDS definitions, and other related documentation requirements
  • Knowledge of and experience in medical record department functions, diagnosis related groups, and prospective payment system
  • Demonstrated knowledge of and skill in customer service, oral communication, written communication, problem solving, quality management, results orientation, teamwork, detail oriented, prioritization, organization, independent work and leadership
  • Formal coding education completed at an accredited certificate program – 1 year minimum – required
4

Coder Job Description

Job Description Example
Our growing company is hiring for a coder. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for coder
  • Enhances professional growth and development through in-service meetings, educational programs, conferences
  • Assist in the development of coding education programs for in-service meetings
  • Tracks denial patterns for surgical practices to address systemic issues
  • Meets designated productivity and coding accuracy rate of 95%
  • Establishing patient account information including demographic and insurance information
  • Assigning CPT4/HCPCS and ICD9/10 Diagnosis coding
  • Submitting all claims to designated carriers both electronically and via the CMS 1500 claim form
  • Insurance processes and reconciliation regarding the denial process
  • Meet coding productivity standards and accuracy rate determined by company policy
  • Keep abreast of coding guidelines and reimbursement reporting requirements
Qualifications for coder
  • Hands-on physician coding experience desired in family practice, internal medicine, OB, pediatrics, etc
  • Medical Chart/charge audit experience desired
  • Encoder experience desired
  • CPC or CCS-P desired
  • Accurately enters coding and charges in to the designated computer software system.*
  • Works with central business office team and revenue support team on resolving claim denials and appeals to assure maximum net revenue in a timely fashion.*
5

Coder Job Description

Job Description Example
Our company is looking to fill the role of coder. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for coder
  • Research and resolve general coding issues
  • Generate and distribute general reports for management review on a routine basis
  • Perform coding audits on a routine basis
  • Establish and maintain strong working relationships with cross-divisional teams
  • Serve as an SME by serving as a resource to immediate team(s), internal and external customers
  • Perform coding audits and review of outpatient provider services to support coding optimization and compliance for the medical group
  • Support multiple specialties across the medical group with coding for evaluation and management and procedural services
  • Work side by side with outpatient providers providing ongoing feedback, coaching, and support with the code entry process, documentation, International Classification of Diseases, Ninth Revision (ICD-9), ICD-10, and Hierarchial Condition Categories (HCC) coding in alignment with current medical group reimbursement requirements
  • Support multiple specialties across the medical group with coding for evaluation and management and procedural services in this entry level position
  • Work side by side with outpatient providers providing ongoing feedback, coaching, and support with the code entry process, documentation, International Classification of Diseases, Ninth Revision (ICD-9), ICD-10, and Hierarchial Condition Categories (HCC) coding in alignment with current medical group reimbursement requirements, in addition to the audit and review work
Qualifications for coder
  • Accurately assigns ICD-10, CPT-4, and HCPCS codes and modifiers for assigned clinics.*
  • Reviews EMR, encounter forms and applies coding training to identify and sequence appropriate ICD-10 to the appropriate CPT code
  • Meets department and system attendance standards.*
  • Actively seeks to promote and helps to maintain a professional, team oriented, service conscious environment, which contributes to the goals of the department and reflects the values of the system
  • Supports chart/claim audit projects.*
  • Current certification as a CPC or CCS-P from AAPC or AHIMA

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