Medical Coders are key members of a team that keeps vital healthcare facilities up and running and saving lives.
Job Tasks:
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Review medical records, provider notes, dictation, and other documentation to determine appropriate procedure codes and diagnosis codes, in accordance with the coding guidelines and federal regulations.
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Utilize appropriate specialized medical classification software to assign procedure and diagnosis codes for insurance billing.
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Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission.
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Conduct medical records research and corresponds with insurance companies and healthcare professionals to resolve issues regarding claims denied for payment.
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Provide feedback to physicians and other providers regarding coding guidelines and requirements.
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Maintain up-to-date knowledge and understanding of coding and insurance processing guidelines with continuing education and training.
Skills and Abilities Needed to Perform Job:
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Experience and knowledge in reviewing and assigning accurate medial codes for diagnoses procedures and services performed by physicians and other qualified healthcare providers.
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Knowledge of ICD-9 and ICD-10 code diagnosis to determine the principal and significant secondary diagnosis.
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Proficient across a wide range of services including E/M, anesthesia, surgery, radiology, pathology, and medicine.
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Knowledge of medical coding guidelines and regulations including compliance and reimbursement.
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Understand how to integrate medial coding and payment policy changes into a practice’s reimbursement processes.
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Knowledge of anatomy, physiology and medical terminology necessary to correctly code provider diagnosis and services.
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Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases and deformities.
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Knowledge and use of Microsoft programs specifically including spreadsheet and word processing software.
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Critical Thinking – Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
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Reading Comprehension – Ability to understand written sentences and paragraphs in work related documents.
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Written Comprehension – Ability to read and understand information and ideas presented in writing.
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Deductive Reasoning – Ability to apply general rules to specific problems to produce answers that makes sense.
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Inductive Reasoning – Ability to combine pieces of information to form general rules or conclusions.
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Information Ordering – Ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules.
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Near Vision – Ability to see details at close range.
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Oral Expression – Ability to communicate information and ideas in speaking so others will understand.
Desired Work Style Attributes:
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Attention to details
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Integrity – Honest and ethical
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Dependability – Reliable and responsible
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Cooperation – Pleasant with others
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Independence – Job requires developing one’s own way of doing things, guiding oneself with little or no supervision and depending on oneself to get things done
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Stress Tolerance – Accepting criticism and dealing calmly in stressful situations
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Initiative – Willingness to take on responsibilities and challenges
Education Requirements:
The minimum education requirements are a high school diploma or equivalent and certification as a professional coder (CPA).
Many online certificate programs in coding can be completed in less than a year, but if you are looking for a degree, an associate degree program is two years and a bachelors is four years of classroom or online study if you participate as a full-time student. Medical coding is not a licensed profession, but credentials do matter. The AAPC reports that certified coders earn an average of 20% more than coders without certification.
Medical coding is not a licensed profession, but credentials do matter. The AAPC reports that certified coders earn an average of 20% more than coders without certification.
New graduates from medical coding schools can often find entry-level employment in smaller physician offices and some health care facilities, but the larger health care practices and organizations will want to see six months to one year of work experience and national certification. Many medical coders take jobs upon graduation and study for the certification exam while employed. In many cases, graduates have had their certification exam costs reimbursed by employers and the work experience gained in that time is invaluable.
You earn certification by passing an examination. There are multiple certifying agencies for medical coders, but they are not all equal. The two that are best known and most respected around the nation are AHIMA and the AAPC. Each offers several credentials.
The American Health Information Management Association (AIHMAZ) offers two certifications The CCS or CCS-P and the RHIT. The American Academy of Professional Coders (AAPC) offers three certifications including, CPC, CPC-H and CPC-P. The AAPC offers the CPC (Certified Professional Coder) certification, which is most useful for coders in physician office settings. There is also the CPC-H, which is for hospitals and the CPC-P, which is geared toward payers (health plans or Medicare).
In addition to basic credentials, there are several specialty credentials offered through the AAPC. These demonstrate advanced knowledge of coding medical specialties.
For a medical coder, education is ongoing. Continuing education is required for recertification through either organization.
Training/Work Experience
You may need some previous work-related skill, knowledge or experience to be a medical equipment preparer.
License and certification are recommended but not required.