Medical Risk Coder
Description POSITION DESCRIPTION: Responsible for the accurate and efficient coding of FHC medical records in compliance with all legal regulations and accepted standards. DETAILED DUTIES AND RESPONSIBILITIES: • Review accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. • Audits clinical documentation and coded data to validate documentation supports diagnoses, procedures and all services rendered for reimbursement and reporting purposes. • Identifies diagnostic and procedural information and reviews physician pending charges for appropriate complexity using CPT coding guidelines. • Assigns codes for reimbursements and compliance with regulatory requirements utilizing guidelines and following up to date coding conventions. • Works closely with the Coding Administrator to provide feedback to providers to improve documentation practices. • Confirm patient demographic, insurance and referring physician information is accurately entered in Intergy. • Enter all codes, CPT, HCPCS and ICD-10 coding and modifiers in Intergy timely and accurately. • Follow established checks and balances systems to ensure complete and accurate code capture. • Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates and Medicare NCCI. • Serves as coding consultant to providers. • Keeps abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and third-party payers. • Keeps abreast of standard coding guidelines (including Medicare, Medicaid, Managed Care, HEDIS, and FQHC guidelines). • Provides updates and status reports to management weekly. • Other duties as assigned. Requirements KNOWLEDGE: • Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment • Medical terminology, CPT, HCPCS and ICD-10 coding and modifier usage required • Understanding of FQHC billing procedures and Sliding Fee Schedules a plus • Understand and adhere to all HIPAA guidelines SKILLS AND ABILITIES: • 2 years' Medical Coding experience required • Certified Risk Coder (CRC) Certification required Apply tot his job