Medical Coder Resume Samples

4.7 (59 votes) for Medical Coder Resume Samples

The Guide To Resume Tailoring

Guide the recruiter to the conclusion that you are the best candidate for the medical coder job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

Craft your perfect resume by picking job responsibilities written by professional recruiters

Pick from the thousands of curated job responsibilities used by the leading companies

Tailor your resume by selecting wording that best fits for each job you apply

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

CHOOSE THE BEST TEMPLATE - Choose from 15 Leading Templates. No need to think about design details.
USE PRE-WRITTEN BULLET POINTS - Select from thousands of pre-written bullet points.
SAVE YOUR DOCUMENTS IN PDF FILES - Instantly download in PDF format or share a custom link.

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

Create a Resume in Minutes
ND
N Denesik
Nash
Denesik
115 Schumm Lakes
San Francisco
CA
+1 (555) 452 8305
115 Schumm Lakes
San Francisco
CA
Phone
p +1 (555) 452 8305
Experience Experience
10/2016 present
Dallas, TX
Certified Medical Coder
Dallas, TX
Certified Medical Coder
10/2016 present
Dallas, TX
Certified Medical Coder
10/2016 present
  • Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD - 10 - CDM, HCPCS and CPT codes
  • Communicate recommendations and/or suggestions to improve performance efficiencies
  • Possess a strong work ethic and high level of professionalism
  • Accurately codes office procedures for providers to ensure proper reimbursement
  • Maintain up - to - date Coding knowledge by reviewing materials disseminated by Department Manager
  • Engage in provider/ department contact and education as the primary liaison for clarification of documentation and coding
  • Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete
04/2012 06/2016
Boston, MA
Remote Medical Coder
Boston, MA
Remote Medical Coder
04/2012 06/2016
Boston, MA
Remote Medical Coder
04/2012 06/2016
  • May be asked to participate in hospital revenue cycle or work flow enhancement/continuous improvement initiatives
  • Work with nationally recognized HIM professionals and a coding team of more than 250 colleagues in 35 states
  • Works closely with the client’s HIM and other support departments
  • Works with cutting edge technology, including various EMR systems, complex abstracting programs and the best encoders in the business
  • Maintain strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release of information
  • Work with cutting edge technology, including various EMR systems, complex abstracting programs and the best encoders in the business
  • Maintain strict patient and provider confidentiality in compliance with all federal, state, and hospital
09/2005 03/2012
New York, NY
Medical Coder
New York, NY
Medical Coder
09/2005 03/2012
New York, NY
Medical Coder
09/2005 03/2012
  • Perform compliance audits for designated providers/centers consistent with established audit protocol
  • Participates in provider/client/network meetings, which may include provider education through written communication
  • Assist in providing coding training to new physicians
  • Work overtime as requested by management
  • Maintains accurate productivity logs and provides this information to management in a timely fashion
  • Provide real time support and coordination with Primary Care Providers and MRA Coders as it relates to coding for HEDIS and STARS
  • Assist Management in assigned tasks and projects as necessary
Education Education
Bachelor’s Degree in Competency
Bachelor’s Degree in Competency
Cornell University
Bachelor’s Degree in Competency
Skills Skills
  • Proficient knowledge of medical terminology, ICD-9 and CPT coding
  • Strong medical coding skills and knowledge
  • Strong ICD10 coding knowledge
  • Gainshare bonus of up to 16% of salary (Gainshare is a bonus program given to all employees based on company profitability)
  • Strong knowledge of GEM mapping
  • Knowledge of and ability to use computer systems and other office equipment
  • Ability to perform detail-oriented work
  • Strong medical skills and knowledge
  • Ability to speak in a group setting. Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form
  • Strong attention to detail
Create a Resume in Minutes
1

Certified Medical Coder Resume Examples & Samples

  • 3+ years of Certified Medical Coder experience in an Acute Care and/or Outpatient setting
  • AHIMA, RHIA or RHIT and/or CCP / CCS
  • Knowledge of coding guidelines, payor guidelines, federal billing guidelines
  • Knowledge of anatomy, physiology & disease processes
2

Medical Coder Resume Examples & Samples

  • Prior experience with coding, reimbursement, and follow-up with insurance companies
  • Tech savvy
  • Solid time management skills
3

Medical Coder Resume Examples & Samples

  • 1+ year of Medical Coding experience
  • ICD-9-CM and CPT Coding experience
  • Orthopedic Coding experience
  • CPC or CCS
4

Medical Coder Resume Examples & Samples

  • Certified Medical Coder with either CPC or CPC-A with high degree of competency
  • Knowledge/experience with ICD-9 and CPT coding
  • High school diploma or equivalent GED required
  • Experience with MicroSoft Office
5

Cpc Fee for Service Medical Coder Resume Examples & Samples

  • · Certified Professional Coder (AAPC or AHIMA)
  • 1 or more years of data analysis experience
  • Strong knowledge of Microsoft Office XP products (Word, Excel, Access)
  • · Familiarity with eClinicalWorks EMR/PM (Desired)
  • Proficient with Medicare Fee For Service, Medicaid and Commercial payers guidelines and regulations
  • Strong knowledge of claims forms, CPT, ICD and HCPCS codes for Primary Care
  • A thorough knowledge of Federal, State and Local regulations related to billing and insurance
  • Knowledge of HMO (managed care - capitation) and Fee For Service (FFS) reimbursement models
6

Medical Coder Resume Examples & Samples

  • Experience with and exposure to compliance matters
  • Specific knowledge of the regulations and guidelines as they relate to documentation and coding
  • Competency with Microsoft Office
  • Solid ability to organize and prioritize workload to manage multiple tasks and meet deadlines
  • Coding certifications (CPC, CCS, CCS-P, CPMA, CEMC or CENTC); compliance certifications (CHC, CPCO) and/or Bachelor's degree
  • 2 years coding experience
  • Revenue management and/or healthcare industry experience
7

FFS Certified Medical Coder Resume Examples & Samples

  • Certified Medical Coder with either CPC or CCS with high degree of competency in this area
  • Prior experience with Medical Office Practice Management System (EMR)
  • Associates or Bachelors’s Degree
  • Strong knowledge of ICD-9/10 coding
8

Certified Medical Coder Resume Examples & Samples

  • HIMA, RHIA or RHIT CCP, and/or CCS
  • 2 years of hospital coding experience
  • Ability to research coding related issues
  • Hospital inpatient coding experience within the past 2 years and be knowledgeable regarding assignment of DRG codes, invasive procedures and co-morbidities which may affect DRG reimbursement, CPT and ICD 9/10 code
  • Ability to read, analyze and interpret medical records
  • Knowledge of 3M database
9

Medical Coder Resume Examples & Samples

  • Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered
  • Provide Cardiology coding support for cardiology procedures including cardiac cath, echo cardiogram, cardiac stress test, etc
  • Requires understanding of the Hierarchical Conditions Category Model (HCC) for Medicare Risk Adjustment
  • Deliver provider support, education and training related to revenue optimization, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards
  • Provide real time support and coordination with Primary Care Providers and MRA Coders as it relates to coding for HEDIS and STARS
  • Perform compliance audits for designated providers/centers consistent with established audit protocol
  • Coordinate with clinical leadership in development of provider training plans and for active support in the training process
  • Organize and schedule periodic training as indicated from audit results, denial and down coding trends, level of service reports, etc. and/or as requested by medical leadership or CBO management
  • Monitor Coding changes to ensure that most current information is available
  • Provide coding support to Central Billing Office as requested
  • Other duties as may be assigned
  • ICD-10 Proficiency Certification required
  • Certified Medical Coder with either CPC, CCS-P
  • Knowledge and experience in health care/managed care environment
  • Direct Cardiology coding experience ideal
  • Certified Cardiology Coder (CCC) preferred
  • Experience with HEDIS performance measures and Medicare STAR ratings
10

Certified Medical Coder / CPC / Educator Resume Examples & Samples

  • Prior work experience with curriculum design combined with stand up and delivery of complex content - specific to medical coding
  • Medical coding certification (AHIMA or AAPC)
  • Computer literate (MS Word, Power Point, Excel)
  • Ability to travel within the assigned region as necessary
11

Certified Medical Coder Resume Examples & Samples

  • Prior coding experience in managed care at least 5 years preferred
  • MRA/HCC coding for CMS model
  • Ability to work remote and independently
  • Drug Screen and Background Check
  • Certified Risk Coder
12

Medical Coder Resume Examples & Samples

  • 3-5 years of Medical Coding experience
  • Certified Professional Coder (CPC)
  • Understand the importance of accuracy related to charge entry
  • Knowledge of standard governmental billing requirements, Payer requirements, and HIPPA regulations
  • Knowledge of insurance guidelines especially Medicare and state Medicaid
  • Hematology and Oncology coding certification
13

Outpatient Certified Medical Coder Resume Examples & Samples

  • 2+ years of Coding experience and knowledgeable regarding assignment of DRG codes, invasive procedures and co-morbidities which may affect DRG reimbursement, CPT and ICD 9/10 code
  • RHIT/RHIA, CCS, AHIMA or CCP certification
  • Knowledge of Coding, Payor, and Federal Billing guidelines
  • Knowledge of Anatomy, Physiology & Disease processes
  • Competence in Coder training
  • CCS and knowledgeable with 3M/HDS coding application
14

Medical Coder Resume Examples & Samples

  • 2+ years of work experience in a Healthcare-setting or equivalent education
  • American Academy of Professional Coders (AAPC) Certified Professional Coder –Apprentice (CPC-A) or American Health Information Management Association (AHIMA) Certified Coding Associate (CCA)
  • Knowledge Medical Terminology and Human Anatomy
  • Computer savvy (40 wpm)
  • (AHIMA) RHIA, RHIT, CCS, CCS-P, approved ICD-10-CM trainer, or approved ICD-10-CM/PCS trainer
15

Certified Medical Coder Resume Examples & Samples

  • Certified Medical Coder with either CPC, CCS, COC or CSSP with high degree of competency in this area
  • Prior 1 - 2yrs coding experience
  • Strong knowledge or certification in ICD-10 coding
  • Previous MRA or Chronic Care coding
  • Ability to visit and educate Clinic Staff
16

Certified Medical Coder Resume Examples & Samples

  • 3 years of Medical Coding experience in an acute care setting
  • Knowledge of coding guidelines, payer guidelines, and federal billing guidelines
  • Knowledge of coding laws and federal law
  • Competent in Coder Training
  • CCS experience and knowledgeable with 3M/HDS coding application
  • Knowledge of anatomy, physiology and disease processes
  • Knowledge of medical terminology $
  • Inpatient experience
17

Certified Medical Coder Resume Examples & Samples

  • CPC or CCS-P Coding Certification or CPC-A with coding experience
  • Ability to drive to provider offices throughout Polk, Osceola, Orange, and Sumter Counties and be on site at provider offices approximately 75% of the time
  • Prior experience in a fast paced insurance or health care setting
18

Medical Coder Resume Examples & Samples

  • 1+ year of related Coding experience (CPT, ICD-9, and ICD-10)
  • Outpatient Coding experience
  • Solid research and analytical skills
  • Data entry background
19

Medical Coder Resume Examples & Samples

  • Experience following-up with insurance companies
  • Prior experience with Managed Care Companies
  • Experience with credentialing
  • Working knowledge of Next Gen or Electronic Health record system
20

Certified Medical Coder Resume Examples & Samples

  • CPC, CRC, or CCS-P Coding Certification or CPC-A with coding experience
  • Minimum of 18 months of prior medical coding experience
  • Ability to drive to provider offices in the Memphis and surrounding areas approximately 3-4 days weekly
  • 2+ years of Medical Coding experience
21

Medical Coder Resume Examples & Samples

  • Bachelor’s Degree in business administration or related field preferred/or a combination of advanced training and experience
  • 2 years of experience with coding and reimbursement activities
  • Demonstrated knowledge of ICD-9 & CPT4 Coding
  • Demonstrated knowledge of computerized billing systems
  • Knowledge of third party insurance billing policies, procedures, regulations and billing requirements and government reimbursement programs
22

Certified Medical Coder Resume Examples & Samples

  • CPC, CRC, or CCS-P Coding Certification
  • CPC-A certification with coding experience
  • Ability to drive to provider offices and be in the field approximately 50%
23

Certified Medical Coder Resume Examples & Samples

  • CPC - A coding certificaiton with coding experience
  • CRC
  • 2+ years of medical coding experience
24

Certified Medical Coder Front Line Leader Resume Examples & Samples

  • Responsible for MRA aspects of market management, including managing the MRA coder team
  • Executes MRA initiatives within the local market
  • Coordinates and deploys MRA training policies/objectives to the local team
  • Plans and directs MRA training techniques and suggests enhancements to existing training programs within existing markets
  • Use detailed analysis/consideration of financial and operational implications to make recommendations to the MSO and physician groups
  • Medicare Risk Adjustment, Documentation and Medicare Advantage experience
  • Knowledge of HCC/Risk coding
  • Professional coding certification such as CPC, CCS-P, CRC, or RHIT
  • Demonstrated experience partnering with senior leadership on strategic initiatives
  • Proven planning, preparation and presentation skills
  • Demonstrated ability to manage multiple projects and meet deadlines
  • Comprehensive knowledge of all Microsoft Office applications
  • Ability to travel throughout the local market approximately 2-3 days weekly with occasional overnight travel
  • Strong collaboration and relationship building skills
  • LPN, RN, or medical school graduate
  • HEDIS experience
  • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
  • Comprehensive knowledge of Medicare policies, processes and procedures
25

Medical Coder Liaison Resume Examples & Samples

  • Evaluate the element of the medical record for diagnosis code selection
  • Must have 3+ years of coding experience
  • Effective Communication and Professionalism
26

Medical Coder Resume Examples & Samples

  • 3+ years of Coding experience
  • Certification in American Health Information Management Association (AHIMA): RHIA, RHIT, CCS, CCS-P, CCA; American Academy of Professional Coders (AAPC): CPC-H
  • Solid assessment and documentation skills
  • Successful completion of a Coding certificate program with AHIMA approval status
27

Certified Medical Coder Resume Examples & Samples

  • CPC, CRC.CCS-P Coding Certification
  • CPC-A with coding experience
  • 18+ months of prior medical coding experience
  • Meidcare knowledge
28

Certified Medical Coder Resume Examples & Samples

  • CPC, CRC or CCS-P Coding Certification
  • 18+ months of medical coding experience
  • Prior experience in a fast paced insurance, health care, or physician office setting
  • Medicare knowledge
  • HCC coding experience not required, but is a plus
  • Associate degree is a plus
29

Medical Coder Resume Examples & Samples

  • 2+ years of ICD.10 coding experience
  • ICD.10 coding certification
  • Experience within Pathology
30

Medical Coder Resume Examples & Samples

  • Associate's and/or Bachelor's Degree in Health Information Management
  • AHIMA certification; Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician (CCS-P)
  • Knowledge of ICD-CM (current edition) and ICD-PCS coding systems
  • Microsoft Office/Suite proficient (Excel and Word
  • 5+ years of Medical Coding experience or related work experience
  • Knowledge of 3rd party payer requirements and Federal / State guidelines and regulations pertaining to Coding and Billing practices
31

Remote Medical Coder Resume Examples & Samples

  • Be a key player in the revenue cycle process by working closely with the client’s HIM and other support departments
  • Be an active participant in client and Precyse staff meetings, training and conference calls, often using online technology
  • Learning is a daily part of your role with Precyse – keep your coding knowledge base current with Precyse University, available to all coding colleagues. We will provide full ICD-10 training and ongoing courses with AHIMA and AAPC approved CEUs at no cost to our colleagues. This education is being used by some of the top health systems in the country
  • Work with nationally recognized HIM professionals and a coding team of more than 250 colleagues in 35 states
  • You’re a key player in Precyse's Compliance Program, demonstrating knowledge of HIPAA Privacy and Security Regulation information, promoting confidentiality in handling patient information
  • Our coding colleagues work for Precyse, coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to Precyse
  • Active RHIA, RHIT, CCS, CCS-P, CPC or CPC-H
  • A minimum of two (2) years’ experience coding patient records in a hospital HIM department
  • Must have a thorough knowledge of medical terminology, anatomy and physiology
  • Must be able to pass a pre-employment assessment
32

Remote Medical Coder Resume Examples & Samples

  • Work closely with the client’s HIM and other support departments
  • Active RHIA, RHIT, CCS, CCS-P, CPC, COC, CIC, or CPC-H
  • Experience coding Inpatient Acute Facility and/or Outpatient medical records
33

Remote Medical Coder Resume Examples & Samples

  • Be an active participant in client and nThrive staff meetings, training and conference calls, often using online technology
  • Learning is a daily part of your role with nThrive – keep your coding knowledge base current with nThrive Education, available to all coding colleagues. We will provide full ICD-10 training and ongoing courses with AHIMA and AAPC approved CEUs at no cost to our colleagues
  • This education is being used by some of the top health systems in the country
  • Work with nationally recognized HIM professionals and a coding team of more than 375 colleagues in 41 states
  • You’re a key player in the nThrive Compliance Program, demonstrating knowledge of HIPAA Privacy and Security Regulation information, promoting confidentiality in handling patient information
  • Our coding colleagues work for nThrive, coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to nThrive
  • Experience coding Inpatient Acute and/or Outpatient medical records
  • Must have a thorough knowledge of medical terminology, anatomy, and physiology
34

Medical Coder & Educator Resume Examples & Samples

  • Review, research and respond to practice billing and coding questions via Ask The Expert (SalesForce) platform within a designated timeframe
  • Collaboration with Radiation and Imaging team, participate in project calls and dashboard creation
  • Collaboration with Innovative Practice services to include answering coding questions and attending meetings
  • Research related to government regulations and commercial payer policies. Prepares and disseminates monthly newsletter
  • Coding changes/annual webinar
  • 2 years project management experience
35

Medical Coder Resume Examples & Samples

  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
  • Clinical and/or coding expertise in the application of medical and reimbursement policies within the claim adjudication process through file review. This could include Medical
  • Director/physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information
  • Performs clinical coverage review of post-service, pre-payment claims, which requires interpretation of state and federal mandates, applicable benefit language, medical & reimbursement policies, coding requirements and consideration of relevant clinical information on claims with aberrant billing patterns
  • Performs clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding & billing
  • Identifies aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommends providers to be flagged for review
  • Maintains and manages daily case review assignments, with a high emphasis on quality
  • Provides clinical support and expertise to the other investigative and analytical areas
  • Participates in provider/client/network meetings, which may include provider education through written communication
  • Participates in training of new staff, and serves as a clinical resource to other areas within the clinical investigative team
  • 2+ years of current CPT/HCPCS coding experience (entering codes, auditing etc.)
  • Possess an unrestricted nursing license (RN/LVN/LPN) or a current certified coder (CPC/CCS/RHIT etc.)
  • Ability to work 8:00 am to 4:30 pm CST Monday through Friday and overtime as business needs require
  • Healthcare Claims experience
  • Managed Care experience
  • Investigational and/or Auditing experience
36

Medical Coder Resume Examples & Samples

  • Understanding of ICD-10 Coding in relation to DRGs
  • Travel up to three days per week to providers offices
  • 2+ years of coding experience
  • AAPC (CPC) or AHIMA (CCS) certification
  • Computer proficiency; can type, create, edit, search web browsers, toggle between multiple screens, use Word, Outlook and navigate in a Windows environment
  • Travel up to 3 days per week to providers offices
  • CCS-P
  • Managed Care / IPA / Health plan experience
  • Bilingual Spanish
37

Senior Medical Coder Resume Examples & Samples

  • *This is an office based position***
  • Support the Risk Adjustment Department in the processing of attestations as well as coding and documentation education to our provider network
  • Travel up to 25% - Orange County and Long Beach,CA
  • CCS or CPC credentials through AHIM or AAPC
  • ICD10 Certification
  • Travel up to 25% in Orange County and Long Beach, CA
38

Medical Coder Resume Examples & Samples

  • Adjudication of claims with zero critical errors
  • Completion of claims in queue within specified time frame
  • Setting productivity benchmark
  • Good written Communication Skills
  • Eye for Details
  • Analytical Skills
  • Professional demeanor
  • Ability to work accurately and efficiently at all times, including those of high processing volume
  • Ability to multi-task and manage time efficiently under the pressure of deadlines
  • Sensitivity to the confidential nature of the data and proprietary company information
  • Flexibility to work in shifts
  • Good Leadership skills (Leader without Title)
39

Certified Medical Coder Resume Examples & Samples

  • Review and assign accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers in the office or facility setting (eg, inpatient hospital)
  • Develop policy and work with Managed Care and Medical Affairs on trends that require payor interaction
  • Update education through online information as well as courses available in order to maintain strong coding skills and knowledge of legal compliance standards
  • Create and maintain reports for coder use in tracking productivity, denials, level of service changes made by coders, and to comply with internal audit standards
  • Reviews all physician documentation to ensure compliance with third party and regulatory guidelines
  • Engage in provider/ department contact and education as the primary liaison for clarification of documentation and coding
  • Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine
  • Understanding of how to integrate medical coding and payment policy changes into a practice's reimbursement processes
  • Knowledge of anatomy, physiology, and medical terminology necessary to correctly code provider diagnosis and services
  • ICD-10-CM Official Guidelines for Coding and Reporting
  • CPT® coding guidelines and parenthetical notes
  • Modifier use
  • Services covered under Medicare Parts A, B, C and D
  • Apply coding to payment policy
  • Place of service reporting
  • Fraud and Abuse
  • NCCI edits
  • NCD/LCD
  • HIPAA
  • ABNs
  • RVUs
  • Ability to apply the above skills and knowledge in audit settings and educate on findings
  • Minimum of 2+ years knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture
40

Medical Coder, Cdst-tricare Resume Examples & Samples

  • Maintain thorough knowledge of coding policies and procedures, and medical terminology/technology
  • Is able to determine benefit and coverage based on TRICARE policy and UHCMV guidelines
  • Consistently meet established productivity, schedule adherence, and quality standards while maintaining good attendance
  • Attend and participate in Prior Authorization List (PAL) Committee and Episode of Care (EOC) Committee and collaborate with PGBA on ensuring coding in CRT is consistent with PGBA processing of referrals/authorizations
  • Work closely with Utilization Management team to ensure timely updates of CRT for change orders and contract modifications
  • Work closely with IT developers on enhancements and releases
  • Able to recode authorization/referral requests to ensure TRICARE coverage and consistency in claims payment (unlisted codes, etc)
  • Assist with annual review of Prior Authorization List and support coding changes as required
  • 1+ years of experience in a medical office or similar setting, in a medically related role such as customer service, administrative support, medical care or clerical related role, or an Associate's Degree (or higher)
  • Certified Medical Coder ( CPC, etc) with current certification
  • TRICARE knowledge and experience
  • Graduate of an Accredited Medical Coding School
  • Ability to navigate a PC to open applications, send emails, and conduct data entry
  • Ability to create, copy, edit, send and save using Microsoft Word, Excel, and Outlook
  • Ability to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86
  • Associate's Degree (or higher) or some college
  • Hospital coding experience
  • Military Service experience
  • Demonstrated attention to detail
41

Certified Medical Coder Resume Examples & Samples

  • Certified Medical Coder with either CPC or CCS with high degree of competency in this are
  • 1-2 years prior coding experience in a medical office or hospital environment
  • Strong knowledge of ICD-10 coding
42

Medical Coder Resume Examples & Samples

  • Understand CPT and ICD coding
  • Evaluates the medical record for procedures and diagnoses documented in the medical record and accurately assigns ICD-10, HCPCSs, Modifiers, and CPT codes, based on National Coding Guidelines
  • Abstract data elements
  • Assists in the identification and recommendation of system edits
  • Code within timeframes established by Allina hosptial coding standards
  • Knowledge of APC classification
  • Will be reviewing provider dictation and charge entry done by business ops personnel to make certain that correctCPT codes are billed and appropriate diagnoses assigned in accordance with Provider dictation
  • Communicate effectively with providers
  • Reports for coder use are created and maintained in both business software applications and are used for tracking productivity, denials, and level of service changes made by coders
  • Update education through online information as well as courses available to them in order to maintain strong coding skills and knowledge of legal compliance standards
  • Knowledge of Medicare/CMS requirement and Allina Policy; will perform the job in accordance with Allina’s Standards of Business Conduct, which include principles of legal compliance, ethics and integrity, confidentiality, protection of assets and avoidance of conflict of interest and inappropriate business relationships
43

Medical Coder Resume Examples & Samples

  • Certified as a professional coder (CPC or CCS-P)
  • 1+ year of medical record coding and record review experience
  • Strong medical coding skills and knowledge
  • Knowledge of ICD-10 and experience working in a managed care health plan organization
44

Medical Coder Resume Examples & Samples

  • Work with cutting edge technology, including various EMR systems, complex abstracting programs and the best encoders in the business
  • Enjoy the benefits and learning experience of being exposed to different HIM environments
  • Be an active participant in client and MedAssets-Precyse staff meetings, training and conference calls, often using online technology
  • Learning is a daily part of your role with MedAssets-Precyse – keep your coding knowledge base current with Precyse University, available to all coding colleagues. We will provide full ICD-10 training and ongoing courses with AHIMA and AAPC approved CEUs at no cost to our colleagues. This education is being used by some of the top health systems in the country
  • You’re a key player in MedAssets-Precyse's Compliance Program, demonstrating knowledge of HIPAA Privacy and Security Regulation information, promoting confidentiality in handling patient information
  • Our coding colleagues work for MedAssets-Precyse, coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to MedAssets-Precyse
  • A passion for coding and the desire to work for a company that values you!
  • 2+ years of experience coding patient records in a hospital HIM departmentt
45

M HIS Senior Medical Coder Resume Examples & Samples

  • Review physician documentation and code diagnoses and procedures using current ICD-10-CM and CPT-4 coding conventions to assure the specificity of diagnoses, procedures and modifiers assignments as appropriate for optimal reimbursement for hospital and/or professional charges
  • Accurately code procedures and diagnosis according to specific policies and procedures
  • Assist with denials related to coding issues as necessary
  • Participate in Quality Management activities, as appropriate
  • Provide client support as needed
  • Perform related work as required and/or assigned. Maintain a 3% error ratio or below for Quality Assurance
  • High School Diploma or higher from an accredited institution
  • AAPC and or AHIMA certification
  • Minimum of one or more (1+) year(s) of experience with medical coding in Radiology setting
  • Associate's Degree in Health Information Management or higher from an accredited university
  • Hold RHIT
  • Certified Interventional Radiology Coder (CIRCC)
  • Extensive knowledge of CPT, ICD-10 coding systems and Coding guidelines
  • Capable of working under time restraints. Excellent oral and written communication skills
  • Ability to plan, organize and prioritize job duties under general supervision
  • Excellent customer service and customer relations skills
  • Time management skills to meet client productivity goals
  • Highly motivated, independent and innovative
46

Senior Medical Coder Resume Examples & Samples

  • Support clinical code reviews
  • Provide support for onsite audit reviews regarding clinical documentation
  • Provide support of new and established group coding for Care Management
  • Create and maintain project plans and documentation related to clinical editing
  • High school education or equivalent experience
  • Certified coder via AHIMA or AAPC or an RN
  • Knowledge of physician coding methodologies including CPT, HCPCS, facility coding methodologies
  • Experience with Windows applications - MS Office, PowerPoint-Creating/Managing Presentations, Excel- Creating/Updating spreadsheets, formulas, and Word- Creating/Updating documents
  • Experience leading and facilitating virtual meetings
  • Excellent verbal and written communication/presentation skills
47

Medical Coder Resume Examples & Samples

  • Ability to review medical record documents to derive at accurate and appropriate ICD10 codes for claims
  • Ability to contact physician’s office to ask additional questions or seek additional information/ records to derive at valid ICD10 code (Strong communication skills and phone etiquette)
  • Ability to collaborate with AR team on denials related to diagnosis codes
  • Certified medical coder
  • Strong ICD10 coding knowledge
48

Medical Coder Ii Flexible Schedule Hrs Per Week Resume Examples & Samples

  • Code medical records using ICD-9-CM and CPT-4 coding rules and guidelines. Ensure thorough and compliant coding to support patient records and submission of billing for payment
  • Participate in special projects and/or completes other duties as assigned
  • 1- 2 yrs medical coding; Endocrinology preferred
49

Medical Coder Resume Examples & Samples

  • Solid problem solving and time management skills
  • Working knowledge of CPT, ICD-10, or ICD-9
  • Previous HEDIS experience
  • Open to Registered Nurse (RN) or Licensed Practical Nurse (LPN)
50

Certified Medical Coder Resume Examples & Samples

  • Certified Medical Coder with one of the following active certifications and with a high degree of competency (CPC, CPC-A, CPC-H, or CPMA from AAPC; or CCA,
  • Knowledge/experience with ICD-10 and CPT coding
  • This role requires travel within the general/local area
51

Medical Coder Resume Examples & Samples

  • Support the Risk Adjustment Department in the review of provider medical records for compliant documentation and coding
  • Identify appropriate assignment of ICD - 10 Codes for Professional services
  • Coding and Documentation Education to our PCP Network
  • HCC education to our Provider and Specialist Network
  • Support the Coding Processors in the review of PCP completed attestation forms
  • Ad Hoc projects as they come up
  • 3+ years coding experience; outpatient or inpatient
  • CCS or CPC credentials through AHIMA or AAPC
  • ICD - 10 Certification
  • EHR experience
  • Computer proficiency; can type, create, edit, search web browsers, toggle between multiple screens, use Word, Outlook, Excel and navigate in a Windows environment
  • Access to reliable transportation that will enable you to travel to Physician offices and company meetings
  • HCC experience
  • Managed care experience
52

Medical Coder Ii Pulmonology New Hire Bonus Resume Examples & Samples

  • Accurately abstract information from the medial records into the appropriate coding systems, ensuring compliance with established guidelines
  • Enter and validate charges using appropriate tools and validates diagnoses with the medical documentation provided
  • Compare charges on accounts with the procedures coded and identifies any discrepancies. Notify Coding Manager of any discrepancies’ and collaborates as needed to rectify the account
  • Identifies trends and educational opportunities to ensure proper coding, documentation, and accuracy of billing within areas of responsibility/specialty
  • Associate degree in related field preferred
  • 2-4 years coding experience required. Pulmonology experience preferred
53

Medical Coder Representative Resume Examples & Samples

  • Performs various clerical functions as requested by the supervisor or group lead
  • Responsibilities include: Applying CPT-4 and ICD-9 codes by translating dictated pathology reports, in a timely and accurate manner
  • Responds to accounts receivable department when coding discrepancies need reviewed due to payor denials
  • Understand and follow all department and company SOP’s
  • Perform special projects as assigned by the manager
  • Ability to work independently and on a team
54

Medical Coder Resume Examples & Samples

  • Updated Medical Coding Certification is mandatory
  • Minimum of 1 years of coding experience in an MLTC preferred but not required
  • Thorough knowledge of ICD-9 and working knowledge of ICD-10 coding is required
55

Medical Coder Resume Examples & Samples

  • Performs clinical coverage review of post-service, pre-payment claims, which requires interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims with aberrant billing patterns
  • Performs clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing
  • Possess an unrestricted Nursing License (RN/LVN/LPN) or are a current Certified Coder (CPC/CCS/RHIT etc.)
  • Ability to work 8:00 am to 5:00 pm CST Monday through Friday and available to work overtime as business needs require
  • Experience with MS Excel with the basic ability to create and save a report
56

Certified Medical Coder Resume Examples & Samples

  • Accurately abstract information from the medical records and accurately assign ICD10 CM with appropriate modifiers and CPT codes
  • Ability to communicate effectively and courteously with staff and others
  • Must be well organized and detail oriented
  • Communicate recommendations and/or suggestions to improve performance efficiencies
  • Dependable, self-starter, and deadline driven
  • Ability to work well independently as well as in a team setting to achieve organizational goals
  • Possess a strong work ethic and high level of professionalism
  • Certified Professional Coder (CPC) and ICD-CM certification proficient are required
  • One to two years of coding experience required
  • Specialty coding experience in GENERAL SURGERY and/or UROLOGY preferred
  • Knowledge of legal and regulatory government provisions
  • Knowledge of insurance rules and guidelines
  • Must maintain absolute confidentiality
57

Medical Coder Quality Analyst Resume Examples & Samples

  • Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD-10) and Healthcare Common Procedure Coding System (HCPCs) guidelines
  • Documents Decisions on reviews through notations and enters notes in appropriate company systems
  • Ability to discuss and present on decisions made to appropriate internal and external individuals/groups
  • Coordinate with team members to understand trends and schemes related to billing issues/coding trends
  • 2+ years of experience in coding and medical billing
  • Associates degree or related field experience
  • Clinical and/or coding expertise in a Physician office, SNF, ALF, Hospital setting, and/or billing/office
  • Strong organizational/time management skills and be able to work independently or as a team
  • Strong knowledge of CMS 1500 and UB04 data elements
  • Strong knowledge of ICD, CPT, HCPC and Revenue Codes
  • Ability to support heavy work load volume and meet unit standards while engaging multiple priorities
  • Current CPC Certification
  • Behavioral Health experience
  • Serves as a resource on moderately complex issues related to coding / billing
58

Medical Coder Resume Examples & Samples

  • Abstracts from patient charts/medical records all billable services in assigned specialties. Staff will translates these services into the correct CPT (Procedure) and ICD (Diagnosis) codes with all necessary and applicable modifiers
  • Staff will conduct training sessions for physicians and staff clinicians in individual or group settings on coding rules and federal regulations. Meets with providers in assigned area on a regular basis to review coding guidelines and identify any updates and changes. Staff will meet with physicians in the clinical setting as needed for documentation instruction
  • Provides education to physicians and staff clinicians in accordance with National Correct Coding Initiative (NCCI) guidelines
  • Provides documentation and coding audits of all billing providers within the practice based on documentation guidelines, Medicare Teaching Guidelines and NCCI coding initiatives
  • Identifies bundled charges and bills appropriately according to University compliance guidelines, federal regulations and NCCI coding initiatives
59

Medical Coder Resume Examples & Samples

  • Prior experience as a Medical Coder I or equivalent work experience
  • Progressive Offers
  • Gainshare bonus of up to 16% of salary (Gainshare is a bonus program given to all employees based on company profitability)
  • Medical, dental, vision and life insurance benefits
  • Ongoing training and opportunities for career advancement
  • Award winning, inclusive environment with Employee Resource Groups
  • 401(k) plan
  • Tuition assistance
  • Employee discounts
  • Child care subsidy
60

Medical Coder Resume Examples & Samples

  • Enter medical billing information into medical audit system (ICD9 diagnosis codes, CPT4 procedure codes)
  • Ensure billing codes correspond accurately with the claim notes
  • Apply all applicable fee schedule and coding rules, making appropriate adjustments where applicable
  • Provide fee schedule reimbursement date for subrogation claims
  • Ensure AOB (Assignment of Benefits) has been submitted to provider
  • Answer incoming calls from customers, providers, billing offices or attorneys; providing timely responses to their claims inquiries
  • Providing timely bill processing
  • Sort incoming bills by coder and distribute accordingly
  • Review unmatched bills and correctly identifying the claim
  • Mail EOB (Explanation of Benefits) statements to providers
  • H. S. Diploma or GED
  • Strong data entry skills, communication & customer service skills
  • Prior CPT-4 and ICD-9 coding experience preferred
  • Prior experience as a Medical Coder I or equivalent work
  • Solid PC skills
61

Inpatient Certified Medical Coder Resume Examples & Samples

  • 2+ years of Coding experience in a Hospital setting
  • RHIT / RHIA, CCS, AHIMA or CCP certification
  • Knowledge of Coding guidelines, Payor guidelines, Federal Billing guidelines
  • Knowledge of Medical terminology
  • Knowledgeable of 3M database
  • Microsoft Office/Suite proficient (Excel, Word, etc.)
62

Health Information Medical Coder Remote Resume Examples & Samples

  • AHIMA credential required: RHIA, RHIT or CCS
  • Must be skilled in inpatient rehabilitation coding with at least 3 years of recent experience in this type of coding
  • This is a remote coder positon
63

Medical Coder Resume Examples & Samples

  • Accurately code pathology reports using the correct ICD and CPT code
  • Quality of coded accessions above 90 percent
  • Productivity Goal of a minimum of 24 per hour (after training)
  • Verify that accounts have accurate CPT coding on hospital reporting
  • Correctly work amendments and addendums
  • Denials and appeals sent from AR representatives
  • Make phone calls and send faxes to doctor offices for updated clinical information as needed
  • Responsible for filing and maintaining confidentiality of sensitive information concerning patients, physicians, employees, clients, vendors and AmeriPath
  • Billing edits specific to business unit and coding procedures
  • Reconciliation measures
  • Audits of coded work/processes
  • Comply with all State, Federal, and professional regulations as well as departmental policies and procedural manuals
  • Adherence to HIPAA Regulations
  • 2+ years of experience in CPT and ICD coding
  • Experience using a computer and Microsoft Office (Word, Excel, and Outlook)
  • AAPC Certified Medical Coder
  • 1+ year in Pathology coding
  • Experience in GE Centricity
  • Experience in Onbase scanning system
  • Ability to read, analyze and interpret pathology reports
64

Optum Data Management Medical Coder Resume Examples & Samples

  • Create medical codesets for a variety of decision support solutions
  • Provide medical coding expertise in the development and implementation of licensed solutions and projects related to health care cost, risk and quality - of - care
  • Consult with internal and external customers or project teams in the use of the drug hierarchy and drug or lab test code sets
  • Develop update processes for codesets to support ongoing operations & management of analytic products
  • Provide coding expertise to projects led by data science and machine - based learning teams
  • Provide occasional project management when necessary
  • Medical coding certification
  • 1+ years as an inpatient facility - based medical coder in the United States
  • 3+ years working with healthcare / clinical claims data
  • Experience using Access (ability to write queries, import files and manipulate data)
  • Experience using Excel (ability to filter, sort, basic functions)
  • Experience using MS - DRGs or other types of global payment systems
  • Experience using online - coding references such as Encoder - Pro
  • Must live in Twin Cities, MN or be willing to relocate
  • Some experience with managing small projects
  • Experience working within a managed care environment from either a payer or a provider perspective
  • Experience with the billing bundled payments
  • Experience using drug and lab test taxonomies
  • Possess recent knowledge and / or experience using other coding systems such as SNOMED or LOINC
  • Demonstrated strong organization skills (e.g., prioritize and manage multiple tasks, meet deadlines, complete complex long - term projects)
  • Utilize your strong interpersonal skills to work cohesively in a team environment
65

Hospice Medical Coder Resume Examples & Samples

  • LPN or LVN licensed in the state where program is located
  • Certified Medical Coder Required
  • Graduate of accredited practical nurse or vocational nursing program
  • Minimum of one-year general nursing experience
  • Community health/Hospice or medical/surgical experience
  • Self-directed with ability to work with little supervision
  • Demonstrate excellent observation, good nursing judgment and communication skills
  • Ability to provide good written documentation in a timely manner
66

Medical Coder Resume Examples & Samples

  • 1 year of experience
  • ICD-10 experience mandatory
  • Understanding of ICD-9 codes and how they will translate to the new ICD-10 code set
  • Strong knowledge of GEM mapping
  • Proficiency in assigning accurate medical codes for diagnoses, procedures and services performed in the outpatient setting
  • Proficiency across a wide range of services, which include evaluation and management, anesthesia, surgical services, radiology, pathology and medicine
  • HCS-D certification or agreement to complete within 6 months
67

Senior Inpatient Medical Coder Resume Examples & Samples

  • Adhere to and maintain required levels of performance in both Coding accuracy and productivity
  • Identify appropriate assignment of CPT and ICD-10 Codes for Physician and facility services provided in an Observation service setting, and Inpatient setting
  • Abstract additional data elements during the Chart Review process when coding, as needed
  • Maintain a thorough understanding of assigned Client Coding specifics
  • Review and maintain a record of charts coded, held, and/or missing
  • 3+ years of Inpatient medical coding experience (hospital, facility, etc.)
  • Experience working in a 200 bedside acute care hospital
68

Medical Coder Analyst, Claims Resume Examples & Samples

  • Undergraduate degree in healthcare management, healthcare informatics, human biology, economics, or other related fields
  • We will also consider candidates with an associate’s degree and significant experience working as a medical coder
  • Certified as Coding Associate Certification (CAA), or equivalent
  • 5+ years of experience working as a medical coder
  • Passion for collaborating with others to identify disease concepts through medical codes and using the medical coding data in novel ways
  • Experience in preparing for transition to ICD-10
  • Experience maintaining code lists and using data management tools such as Excel, Tableau, and other is highly preferred
  • Strong problem solver with ability to research and frame answers to ambiguous coding questions
  • Self-starter able to work independently and deliver quality end-products in an entrepreneurial environment
  • Of mature disposition and personable; history of working as a team player in a dynamic and changing environment
  • Able to work well within teams across continents/time zones
69

Certified Medical Coder Resume Examples & Samples

  • Displays willingness to speak up about safety issues or change practices to enhance safety; asks for help when needed; enhances teamwork; follows the safety literature/policies
  • Coding Technical Skills –Regulatory coding (ICD-10-CM and HCPCS/CPT) and associated reimbursement knowledge
  • Organization– Able to work independently; proactively prioritizes needs and effectively manages resources and time
  • Other General Technical Skills –
  • Minimum (2) years experience in outpatient coding and/or Health Information Management REQUIRED
70

Medical Coder Resume Examples & Samples

  • Certified Medical Coder with one of the following active certifications and with a high degree of competency (CPC, CPC-A, CPC-H, or CPMA from AAPC; or CCA, CCSP, CCS from AHIMA)
  • Position will require some weekly travel to offices within assigned area
  • Knowledge of MRA and HEDIS
  • Knowledge of ICD-10
71

Medical Coder Resume Examples & Samples

  • Assign primary and secondary diagnosis and E/M level of service for both professional and facility components
  • Assigning appropriate disposition codes
  • Assigning appropriate physician number to each chart
  • Assigning appropriate ICD-9 and CPT codes (s) per client and payer specifications
  • Coding assigned facilities in a timely manner while adhering to quality standards
  • Entering down coded records into the coding system
  • Building strong knowledgebase of proprietary coding system
  • Reporting coding issues to the Coding Production Manager as appropriate
72

Medical Coder Resume Examples & Samples

  • Assigns CPT procedure codes for clinician services to assure appropriate billing and reimbursement
  • Assigns diagnostic (ICD-9-CM and/or procedural codes (ICD-9-CM & CPT) on all medical record types at an advanced level to ensure proper reimbursement and accurate data base information
  • Assigns modifiers to codes
  • Input charges for all urgent care and clinic centers on a daily basis
  • Obtain insurance referrals and verify insurance coverage on a daily basis
  • File claims to the appropriate insurance company on a daily basis
  • Post all copayments and self-pay payments and reconcile on a daily basis
  • Send refunds to both patientand insurance carrier if there is an overpayment
  • Reviews charts and provides one-to-one and group educational feedback to the clinicians
  • Interacts with clinician and other clinic/corporate departments to assure compliance and appropriate billing practices
  • Gather data and prepare information/reports as requested by Division Director of Medical Billing
  • Handle billing correspondence
  • Maintains confidentiality in all aspects of the job
  • Minimum 3 years specialty billing/coding in the area of internal medicine, family medicine and/or emergency medicine
  • Ability/knowledge to code multiple specialties
  • Knowledge of patient insurances. Ability to provide instruction to the patients and their families regarding insurance coverage procedures
  • Ability to perform standard office procedures according to established protocols
  • Experienced and comfortable providing education to providers one on one and in group setting on a frequent basis and work with the providers to optimize their billing
  • Knowledge of and ability to use computer systems and other office equipment
  • PC skills, with emphasis on Windows applications, and ability to use a mouse
  • Keyboarding/data entry skills
  • Ability to perform detail-oriented work
  • Thorough knowledge of medical terminology, anatomy, physiology and disease process
  • Ability to work independently yet in conjunction with a team
  • Ability to adapt to a changing and growing atmosphere
  • Good time management and organizational skills
  • Knowledge of medical reimbursement methodologies
  • Ability to speak in a group setting. Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form
  • Courteous and professional demeanor
  • Willingness to work as a team player to meet common goals of the department
  • Demonstrates excellent verbal and written communication skills
  • Ability to maintain a professional demeanor and composure when handling difficult clients/stressful situations
  • Promote positive department morale through effective teamwork
  • The employee must have the ability to work overtime hours when necessary
  • Willingness to learn new skills and help in different areas
73

Medical Coder Supervisor Resume Examples & Samples

  • Monitor and plan for incoming coding volume
  • Schedule and monitor weekly and daily workflows for coders to insure compliance with month end schedule
  • Maintain employee PTO schedules and request overtime as needed
  • Monitor completion and submission of daily production reports by each coder and prepare weekly production status report
  • Coordinate with trainer to ensure updates to Contract Information Sheets, Coding Contract Information Sheets, Revenue Center Listings, Coding Sheets, and Policy & Procedure manuals are distributed and reviewed by staff
  • Assist manager with maintenance of manuals, newsletters, reference materials, etc
  • Assist with interviewing applicants for potential employment, process all new employee paperwork
  • Assist with annual review evaluations for all Coding department employees
  • Assist with coding and/or correcting charts sent for review from other departments
  • Act as technical resource to coders on issues regarding coding or MRTS
  • Review & monitor employee hours in Kronos
  • Works with manager to develop and implement corrective action and/or disciplinary action
  • Establish and monitor QA production schedule for seniors
  • Review patient complaints from the Patient Services Department
  • Proficiency in ICD-9 and ICD-10 diagnostic coding and CPT procedural coding
  • Extensive knowledge of medical terminology, regulatory requirements, and physician billing and reimbursement
  • Effective organizational, analytical, and communication skills
  • Working knowledge of Microsoft Word and Excel
  • Minimum high school diploma or equivalent, B.S. or B.A. preferred or equivalent of management/supervisory experience in physician billing related field
  • CPC or CCS-p certification preferred
  • 1-2 years in a work leader, auditor, or supervisory position
  • 2-4 years previous medical coding experience, emergency medicine experience preferred
  • Manages Clerk(s), Coder(s), and Senior Coder(s)
74

Medical Coder Resume Examples & Samples

  • Review medical records and assign the appropriate Evaluation & Management codes, procedure codes, diagnosis code and modifiers using ICD-10-CM, CPT-4 and HCPCS coding guidelines
  • Communicate coding problems or irregularities to the Billing Operations Manager
  • Communicate with the physicians regarding chart documentation questions and issues
  • Note and communicate trends in physician documentation with the Medical Director over the specific market and/or clinic
  • Assist in providing coding training to new physicians
  • Assist in providing annual coding refresher training to all physicians
  • Maintain working knowledge of medical terminology, coding guidelines and regulations
  • Posts all time of service payments and researches batches that are out of balance
  • Works closely with the Accounts Receivable and Customer Service representatives to assist with payment denials, appeals and patient related coding questions
  • Works in a team-oriented environment to achieve organizational goals
  • Attends training sessions and meetings as required
  • Performs other duties as requested
75

Certified Medical Coder Resume Examples & Samples

  • Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete
  • Accurately codes office procedures for providers to ensure proper reimbursement
  • Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD - 10 - CDM, HCPCS and CPT codes
  • Coding credential required (RHIA, RHIT, CCS, CCS-P, CPC, CPC-H)
  • 3+ years' PCP / Outpatient coding experience
76

Medical Coder Resume Examples & Samples

  • Adhere to and maintains required levels of performance in both coding accuracy and productivity
  • Identify appropriate assignment of CPT and ICD - 9 Codes for Physician and facility services provided in an observation service setting, and outpatient setting
  • Maintain up - to - date coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, among others
  • 2+ years' experience outpatient coding
  • Experience with MS Office (i.e. Word, Excel, Outlook)
  • Familiarity with the multiple computer systems used in HIM (Encoder, EMR, EPIC, Billing / CDI Systems)
  • Coding Certification
77

M HIS Senior Medical Coder Resume Examples & Samples

  • High School Diploma/GED or higher from an accredited institution
  • Minimum of three (3) years of combined experience in physician and facility Diagnostic Radiology and/or Interventional Radiology coding and auditing
  • Certification in AAPC and/or AHIMA
  • ICD-10 trained
  • Associate’s Degree in Health Information Management
  • Hold a certification of any of these credentials; CPC, CPMA, CCS, CCS-P, RHIT, RHIA, RRC, CIRCC
  • Experience in both vascular and non-vascular interventional radiology coding
  • Strong attention to detail, capable of working under time restraints
  • Must have good research skills
  • Excellent customer service and customer relation skills
  • Highly motivated, independent and innovative. Strong team player
78

Medical Coder Resume Examples & Samples

  • Identify errors, problems, or issues and present to Coding management for resolution
  • Attend departmental and training meetings a scheduled
  • Extensive knowledge of ICD-9 and ICD-10 diagnostic coding and CPT-4 procedural coding
  • Typing speed of 35-45 WPM
79

Remote Medical Coder Resume Examples & Samples

  • Select and sequence ICD-9, ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Acute Inpatient , Observation/Rehabilitation/Psychiatric/SNF; Ambulance and Ambulatory Surgery; Emergency Department, Ancillary (Diagnostic)/ Recurring; Interventional Radiology; Injection and Infusion, Hospital Clinic; Wound Care, Physician Pro Fee; Technical Fee; Evaluation and Management and any associated charge capturing with any patient type
  • Performs coding to maintain work volume to include claim edit resolution and data quality reviews on outpatient encounters to: validate the ICD-10—CM, CPT and HCPCS level II code assignments, modifiers, APC groupings, missed secondary diagnosis and procedures
  • Ensure compliance with CMS’s Diagnostic Coding Guidelines for Hospital-based Outpatient Services
  • May be asked to participate in hospital revenue cycle or work flow enhancement/continuous improvement initiatives
  • Monitors daily workload for coders and assures distribution of work is appropriate to ensure timely coding to meet Service Level Agreement
  • Reports issues to management as appropriate which impact operational flow of work
  • Assists with training and orientation of new coding colleagues, development of coding job aides to improve understanding of coders as appropriate and requests from Patient Financial Services or Care Management
  • Completes reports and distributes as requested
  • Complete assigned work functions utilizing appropriate resources
  • Maintain strict patient and provider confidentiality in compliance with all federal, state, and hospital
  • Laws and guidelines for release of information
  • Participate in client and Precyse staff meetings, trainings, and conference calls as requested and/or
  • Maintain current working knowledge of ICD-9 and ICD-10 and/or CPT/HCPCS and coding guidelines,
  • Government regulations, protocols and third-party requirements regarding coding and/or billing
  • Participate in continuing education activities to enhance knowledge, skills, and maintain current
  • Credentials
  • Support Precyse’s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA
  • Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient and/or client information
  • Radiology Certified Coder (RCC)
  • Minimum of two years technical coding experience that includes complex outpatient ambulatory services and ancillary coding or demonstrated level of higher proficiency such as
  • Interventional radiology, wound care, oncology and relevant hands-on coding experience
  • CRC – Certified Risk Adjustment Coder
  • Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-9/10 and CPT/HCPCS code sets (knowledge of ICD-10 code set required effective
  • October 1, 2015)
  • Proficient computer knowledge including MS Office (Outlook, Word, Excel, Power Point)
  • Must display excellent interpersonal and problem solving skills with all levels of internal and external customers
80

Medical Coder Resume Examples & Samples

  • Medical Coding and Billing
  • Clinical Workflow knowledge
  • Proficient in Microsoft Word, Outlook, and Excel
  • High level of organization with the ability to multi-task effectively
  • Self-motivation with a proven ability to learn quickly, multi-task, and work independently
  • Flexibility to respond in a fast-paced, diverse, and changing environment
  • Organized, disciplined and detail oriented
  • 2 years of relevant and recent work experience in the medical coding field
  • ICD-10 CM Certified
  • EHR knowledge strongly preferred
81

Office Based Certified Medical Coder Resume Examples & Samples

  • Perform Coding duties as appropriate according to pre - determined schedules
  • Participate in Coding department meetings
  • Maintain up - to - date Coding knowledge by reviewing materials disseminated by Department Manager
  • 3+ years of coding experience in Family Practice/Internal Medicine
  • Experience Coding from paper charts as well as EMR
  • MS Office experience required i.e. Word, Excel, Outlook
82

Medical Coder Resume Examples & Samples

  • Accurately analyzes provider documentation and ensure that appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT codes
  • Follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
  • Evaluates medical records for consistency and adequacy of documentation
  • Maintains compliance standards as per the policies and reports compliance issues as required
  • Bachelor’s degree in any stream (preferably Life Science)
  • Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC) with knowledge of HCPCS, ICD, CPT, and DRG preferred
  • Minimum one year of experience in medical coding
  • Knowledge of ICD-10 coding preferred
  • Analytical thinking and problem solving skills
  • Excel proficiency
  • Ability to work independently and accomplish targets in a timely manner
83

Medical Coder, Pathology Resume Examples & Samples

  • Effectively communicates with superiors, peers, billing reps, and others, as appropriate, on regular basis, assuring proper flow of information
  • Active AAPC coding certification CPC or CCS
  • AAPC ICD - 10 certification
  • Working knowledge of medical terminology
  • 2+ years experience in medical coding
  • 2+ years of related work in billing or laboratory testing
  • Pathology coding experience
84

Remote Medical Coder Resume Examples & Samples

  • Maintain current working knowledge of ICD-9 and ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing
  • Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials
  • Management when there is a compliance concern or incident; demonstrating knowledge of HIPAA
  • Privacy and Security Regulations as evidenced by appropriate handling of patient information
  • Ambulatory Surgery; Wound Care, Emergency Department, Ancillary (Diagnostic)
  • Recurring; Interventional Radiology; Hospital Clinic; Physician Pro Fee; Technical Fee
  • Evaluation and Management
  • As well as ICD-9/10 and CPT/HCPCS code sets (knowledge of ICD-10 code set required effective
  • Ability to consistently code at 95% threshold for both accuracy and quality while maintaining
  • Client-specific and/or Precyse production and/or quality standards
  • Proficient computer knowledge including MS Office (Outlook, Word, Excel)
  • Must display excellent interpersonal and problem solving skills with all levels of internal and
  • And experience
85

Inpatient Certified Medical Coder Resume Examples & Samples

  • 2+ years of Hospital Inpatient Coding experience
  • Knowledgeable regarding assignment of DRG codes, invasive procedures and co-morbidities which may affect DRG reimbursement, CPT and ICD 9/10 code
  • Working knowledge of Medical Terminology
86

Specialty Practice Medical Coder Resume Examples & Samples

  • 2+ years of specialty Practice Coding experience
  • ICD-10 certification
  • Knowledge of Anatomy and Medical Terminology
  • Working knowledge of Regulatory requirements related to Healthcare Operations and their impact on Practice Operations
  • Associate's and/or Bachelor's Degree in a related field
  • Experience with ENT, Neurology, Plastic Surgery, etc
87

Medical Coder Outpatient Resume Examples & Samples

  • Prior work experience utilizing ICD10 codes
  • Knowledge of legal, regulatory and policy compliance issues related to medical coding and documentation and billing procedures
  • Ability to analyze, problem-solve, and work independently
  • Ability to provide guidance and training to professional and coding staff
  • Knowledge of University policies and procedures is necessary
  • Prior Evaluation and Management or Emergency Medicine coding experince preferred
88

Medical Coder Resume Examples & Samples

  • Preferably 3 years of data management experience and the majority of this with medical coding
  • Preferably 2 years of experience in Information Technology
  • Preferably knowledge of Clinical Development
  • Preferably experience in project management
89

Remote Medical Coder Resume Examples & Samples

  • Works closely with the client’s HIM and other support departments
  • Works with cutting edge technology, including various EMR systems, complex abstracting programs and the best encoders in the business
  • Learning is a daily part of your role with nThrive – keep your coding knowledge base current with Precyse University, available to all coding colleagues. We will provide full ICD-10 training and ongoing courses with AHIMA and AAPC approved CEUs at no cost to our colleagues. This education is being used by some of the top health systems in the country
  • Works with nationally recognized HIM professionals and a coding team of more than 375 colleagues in 41 states
  • You’re a key player in nThrive Compliance Program, demonstrating knowledge of HIPAA Privacy and Security Regulation information, promoting confidentiality in handling patient information
  • Our coding colleagues work for MedAssets-Precyse, coding records for multiple clients where the hospital has outsourced either all or a part of the coding functions to nThrive
  • Experience coding Inpatient Acute and/or Outpatient records
  • A minimum of two (2) years’ + experience coding patient records in a hospital HIM department
90

Certified Medical Coder Resume Examples & Samples

  • Previous inpatient and outpatient coding experience with experience in Medicare and Medicaid coding preferred
  • RHIA, RHIT, CCS, CCS-P, CCA, or CPC credentials required
  • Basic knowledge of medical terminology, anatomy and physiology, and coding systems
91

Medical Coder Resume Examples & Samples

  • Adheres to and maintains required levels of performance in both coding accuracy and productivity
  • Identify appropriate assignment of CPT and ICD-10 Codes for physician and facility services
  • Provide documentation feedback to Providers, as needed, and query physicians when appropriate
  • Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by CDQI Management and Optum
  • Travel to provider offices for feedback and training three days per week on average
  • 1+ year coding experience using CPT/ HCPCS/ ICD-10 codes in an inpatient or outpatient setting
  • Familiarity with multiple computer systems used in HIM
92

Medical Coder, Contingent Worker Resume Examples & Samples

  • Medical Coding Certificate
  • Two years’ experience using ICD-10-CM
  • Computer competency
93

Certified Medical Coder Resume Examples & Samples

  • 2+ years of experience in Medical Coding (ICD-10, CPT, and HCPCS) Testing required
  • If selected for this role, you will be required to complete and pass a background check/investigation for AHCA compliance
  • Bi-lingual English/Spanish highly desired
94

Senior Medical Coder Resume Examples & Samples

  • Coding credential required (CCS, CCS-P, CPC)
  • 2+ years of coding experience using CPT/ HCPCS/ ICD-10 codes in an inpatient or outpatient setting
  • 2 + years of experience with HCC
  • Experience coding from paper charts as well as EMR
95

Medical Coder Resume Examples & Samples

  • Analyzes, sequences and validates assigned codes based on medical record documentation using the automated encoder, book and coding compliance resources
  • Demonstrates complete understanding of coding rules, anatomy, physiology and medical terminology to appropriately code patient information
  • Reviews all medical record documentation to determine and assign diagnoses, procedures, level codes and modifiers
  • Selects the appropriate reimbursement grouper based on financial class for the particular account
  • Ensures that coding compliance, regulatory and reimbursement requirements are met through the process of assigning reimbursement classifications
  • Abstracts and enters demographic, clinical and related patient information into the computer system
  • Assess adequacy of documentation and queries physicians and other healthcare providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding and grouping
  • Reconciles, identifies and retrieves medical records to be coded
  • Maintains a 95% ongoing accuracy rate
  • Consistently achieves daily coding output within the minimal productivity standards set by MACC. Self-manages and prioritizes work flow to achieve timely submission of claims and optimal productivity
  • Maintains accurate productivity logs and provides this information to management in a timely fashion
  • Assists in the orientation and development of new coding personnel
  • Assumes professional responsibility for development of skills and ongoing education to maintain certification
  • Remains abreast of developments in health information management by pursuing a program of professional development, attending educational programs and meetings and reviewing pertinent literature
  • Continuously monitors medical record documentation, individual performance and department workflow as related to the coding function to identify problems and potential solutions (especially related to errors and compliance issues). Communicates with the Operations Manager to find solutions and implement changes to increase productivity and department efficiency
  • Performs all duties and interacts with others in a professional manner
  • Two years of Outpatient Coding experience required
  • Must meet CPC Certification eligibility requirements and must obtain CPC Certification within 3 months of position
  • Comprehensive understanding of ICD10 and CPT coding
  • Demonstrated ability to create strong working relations with physicians and practices
  • Capable of working independently as well as in a team environment
96

Medical Coder / Call Center Collections Resume Examples & Samples

  • Certified Coder
  • 2 Years Experience in Field
  • Call Center Experience
  • Collections Experience
97

Medical Coder, Pathology Telecommute Resume Examples & Samples

  • Responsibilities include: Applying CPT - 4 and ICD - 10 codes by translating dictated pathology reports, in a timely and accurate manner
  • Responds to accounts receivable department when coding discrepancies need reviewed due to payer denials
  • Active AAPC coding certification CPC or Active AHIMA coding certification CCS
  • Experience working in a measured production and quality based environment
98

Medical Coder Resume Examples & Samples

  • Compile, abstract and maintain patient medical records to document condition and treatment. Actively code diagnoses (ICD-9) based on medical record documentation
  • Review records for completeness, accuracy and compliance with regulations. Protect the security of medical records to ensure that confidentiality is maintained
  • Participate in inter-rater reliability testing/peer review exercises, as requested
  • Experience with commercial claims and/or medical/surgical products or Medicare advantage or Medicare fee for service program coverage, the Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD-9, ICD-10) information
  • Knowledge of coding International Classification of Diseases, 9th Revision (ICD-9) codes
  • Understands and applies appropriate Centers for Medicare & Medicaid Services (CMS) guidelines to coding
  • Knowledge of anatomy, physiology and medical terminology
  • Excellent verbal, math and written communication skills
  • Data entry
  • ------------------------------------------------------------------------------------
99

Medical Coder Resume Examples & Samples

  • Responsible for conducting non-routine audits, documenting & communicating findings and recommendations, explaining regulatory requirements, and overseeing the corrective actions for audits
  • Conduct risk assessments and preparation of work plans
  • Develop an understanding of the operations, system processes and procedures used in areas being audited
  • Review and test for compliance with institutional policies and procedures, applicable laws and regulations through the inspection of physical operations, processes, retrieval and review of documents and investigation of irregularities and errors
  • Compile information and/or prepare reports and analyses setting forth results of compliance audits with appropriate recommendations; perform subsequent audits to ensure complete and appropriate corrective action
  • Develop recommended corrective actions to address issues detected
  • Actively participates in exit conferences, providing clarification and supporting information necessary
  • Bachelors degree and coding certifications REQUIRED**
100

Medical Coder Resume Examples & Samples

  • Assists the Business Office and external agencies in clarification of coding regarding reimbursement issues. Handles all requests in a timely fashion
  • Corresponds with other areas of the HIM department to ensure the necessary components are available for accurate coding and the highest quality of the patient's medical record
  • Maintains an accuracy rate of not less than 93% based on internal and/or external review and a productivity standard per 8 hour day, engages in problem identification and solving, and assists in data gathering and chart auditing as necessary
  • Demonstrates competencies in the service to our patients/customers of all ages by obtaining information in terms of customer needs. Speaks in a positive, professional manner about co-workers, physicians, and the facility
  • Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. Participates in educational programs, in-services, and training sessions in an effort to share his/her own expertise with others and further the quality of education and personal growth provided to new personnel, volunteers, and interning students
101

Certified Medical Coder Resume Examples & Samples

  • Proficiency in Microsoft Office: Excel, Word, Access; Outlook; Internet
  • Business analysis knowledge: Skilled to work in a fast paced environment. Must have strong analytical and problem solving skills
  • Customer service: Skilled to communicate with all levels of management, internal and external customers
  • Ability to work well as a member of a team or independently
  • Business Communication: Must be able to effectively communicate across technical and business constituencies in writing effective business specifications and requirements
  • Managed Care Coding experience required; knowledge of industry and regulatory requirements regarding coding required; risk adjustment experience preferred
  • Two to five years related experience required
  • Coding Certification required; CPC or equivalent certification by AAPC
  • Strong understanding of all coding guidelines including NCCI edits
  • Must be ICD10 certified
  • Experience reviewing medical documentation according to both Medicare and Medicaid regulations
  • Risk Adjustment Coding experience preferred
  • AA/AS - Associates Degree or equivalent required
  • BA/BS - Bachelors Degree or equivalent preferred
  • This is not a remote or work from home position. Position requires working in our Queens office
102

Medical Coder Resume Examples & Samples

  • Must perform all essential duties and responsibilities of the Medical Coder position
  • Respond to Revenue Integrity Report findings and make applicable coding additions or corrections
  • As delegated, review Compliance audit findings, respond and/or correct billing system within allotted timeframe for coding corrections
  • Conduct training and maintain training checklists and reference material in cooperation with Management
  • Perform QA ailment hold review and related training as needed. Report findings to Management
  • Act as a resource to Medical Coder/Charge Poster teams for policy and/or process related coding questions
  • Assist Management in assigned tasks and projects as necessary
  • Be “Super User” for all related Revenue Integrity systems. (Intergy, Clinical R&V, G4 Studio, OWAN)
  • Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates and Medicare NCCI
  • Detail oriented and possesses excellent analytical skills
  • Work under limited supervision with ability to understand and meet deadlines as workload necessitates
  • Ensure applicable laws and regulations of working with confidential information are adhered to
  • Meet department productivity standards
  • Consistently reports to work on time and prepared to perform duties of position
  • Demonstrate flexible and efficient time management and ability to prioritize workload
  • Communicate regularly with Management about Department issues or process improvement initiatives
  • Medical Billing/Coding Diploma or Certificate Required
  • 2 or more years of coding experience in hospital or medical office setting required
  • Proficient knowledge of medical terminology, ICD-9 and CPT coding
  • Excellent computer skills including Microsoft Office especially Word and Excel
  • Strong command of English language
  • Ability to communicate clearly and effectively verbally and in writing
103

Medical Coder Resume Examples & Samples

  • Confirm patient demographic, insurance and referring physician information is accurately entered into practice management system
  • Confirm insurance verifications and authorizations, as required
  • Communicate with Financial Counselors regarding insurance authorizations and referrals
  • Review daily physician schedules and evaluate office consults and office visits for appropriate complexity using CPT coding guidelines
  • Enter all CPT and ICD-9 coding into practice management system timely and accurately for code capture
  • Enter all word codes into practice management system per company policy and procedures
  • Follow established check and balance systems to ensure complete and accurate code capture
  • Respond to audit findings and make applicable coding additions or corrections
  • Update practice management system patient’s account notes with any changes made to patient information or as otherwise dictated by company policy and procedure
  • Confirm all documentation required for coding is complete and meets required regulations
  • Must be able to plan and prioritize workflow
  • Experience in hospital or medical office setting
104

Medical Coder / Educator Resume Examples & Samples

  • Certified Professional Coder Certification (AAPC)
  • Extensive travel outside the office is required and a valid driver’s license is required. Travel could be up to 50%
  • Must have reliable transportation with valid driver’s license and insurance
  • Strong written and verbal communication skills; strong work analytical, organizational and time management skills are required
  • Professional demeanor and appearance, strong work ethic, reliable, resourceful, enthusiastic, team player with a positive attitude
  • Comprehensive knowledge of Microsoft Word and Excel and Access
  • Bachelor’s Degree in Business or a related field
  • Prior Coding experience, preferably in a medical office
  • Extensive knowledge of multiple types of Current Procedural Terminology and Healthcare Common Procedure coding systems
  • Knowledge and experience in a health care environment/managed care
105

Senior Medical Coder Resume Examples & Samples

  • Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether a) the diagnosis codes are supported by the documentation and agree with ICD 10 Guidelines for Coding and Reporting
  • Review all medical record documentation for HEDIS and STARs capture and closure. Participate in and support internal and external prospective and retrospective reviews and audits
  • Educate and advise providers and their staff on proper code selection, documentation guidelines as well as assist with training and education for new hires
  • Identify training needs, prepare summary reports and conduct coaching as appropriate for clinicians and other staff to improve the quality of the documentation to accurately reflect the burden of illness for our patients
  • Serve as project and process SMEs when needed
  • High school education or GED
  • AAPC or AHIMA certified medical coder with a minimum of CPC credential and not limited to CRC, CPC-P, CCS and COC
  • 3+ years of experience in medical coding
  • 1+ years of HCC coding experience
  • Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision
  • Basic Microsoft office skills: Word, Excel, PowerPoint
  • Ability to travel locally to various IPA sites
  • Advanced understanding of medical terminology, pharmacology, body systems / anatomy, physiology and concepts of disease processes
  • 1 year of HCC coding in Medicare
  • Ability to code from a variety of electronic medical records systems
106

Medical Coder Resume Examples & Samples

  • This position is responsible for the accurate coding of medical records according to current ICD 9/10 guidelines as well as reporting to leadership on various coding metrics
  • Review insurance payments and denials and recommends coding corrections
  • National coding certification from AAPC or AHIMA to include one or more of the following: Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT)
  • Experience working with the Affordable Care Act and Medicare Advantage (preferred)
107

GI Medical Coder Resume Examples & Samples

  • Interpret medical record data in order to process physician and/or facility charges
  • Three years of medical chart abstraction and coding experience or relevant work experience required
  • Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases
108

Medical Coder Resume Examples & Samples

  • Bachelor's degree in health sciences, health management, or nursing
  • 5 years of ICD-9 coding or medical record audit experience in a consultative role
  • CPC or CPMA from an accredited source or equivalent certification
109

Medical Coder Resume Examples & Samples

  • Provide clinical coding expertise assuring that the ICD-10 CM/PCS code set and other coding is implemented in a consistent, justifiable manner
  • Review clinical documentation and diagnostic results to extract data, and apply the appropriate ICD-CM/PCS and CPT-4 codes for billing, internal and external reporting, research, and regulatory compliance. Codes inpatient and outpatient conditions and procedures as documented in ICD-CM Official Guidelines for Coding and Reporting
  • Resolve errors associated with billing and claims processing; identify and report error patterns; and design workflow changes to reduce errors
  • Coordinate and facilitate annual code updates with program staff
  • Assist in reviewing and validating MMIS ICD-10 modifications
  • Coordinate with program and operations staff, and MMIS IT to update, and maintain ICD logic; and help resolve mapping discrepancies
  • Reviews provider documentation to determine principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures. Resolve questions with provider
  • Verify and abstract specific clinical and demographic data, APR-DRG assignment, and APG/EAPG outpatient assignment
  • Assure appropriate diagnosis and grouper assignment. Extract required information from source documentation and enter into system
  • Identify and report non-payment Provider Preventable Conditions (PPC)
  • Review error reports; correct or complete missing data elements
  • Act as a resource for staff on coding issues, monitor changes in regulations that impact clinical documentations, reimbursement and coding and disseminate changes in coding rules
  • Ensure that computer systems are updated with annual code changes and updates
  • Produce clinical data and statistical reports for clinicians, researchers, financial and business planning, and clinical quality support services
  • Review training and communications materials and billing instructions, and oversee staff training
  • Three to five years of coding experience in a health care setting (i.e. hospital, large physician group practice, health plan, etc.)
  • Proficient in ICD-9-CM ICD-10-CM/PCS and CPT coding system, DRG, APG, MS-DRG and APCs and official coding guidelines
  • Ability to plan and prepare for ICD-10CM/PCS updates
  • Knowledgeable in medical terminology, anatomy and physiology, abnormal lab results, disease processes, and pharmacology-drug names
  • Basic computer knowledge and familiarity with systems used in healthcare, proficiency with Microsoft Office
  • Ability to work independently, and in a matrixed, team oriented, fast paced project environment
  • RHIA, RHIT, CCS, or CPC certification
  • Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines
  • Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed
110

Medical Coder Resume Examples & Samples

  • 2 + years of experience in Medical Billing
  • Able to respect and maintain patient confidentiality at all times
  • Bi-lingual English/Spanish desired
  • 5 years of experience in Medical Coding (ICD-10, CPT, HCPC) and Billing