Medical Coder IV

Mercy Medical Center

This position supports Mercy's philosophy of patient centered care by the timely and accurate coding of hospital or professional services using ICD-10-CM/PCS and CPT/HCPCS classification systems for the purpose of reimbursement, research, and statistics in compliance with federal regulations.
Job Duties
  • Codes the correct principal/primary diagnosis consistent with established coding guidelines (95% or greater accuracy).
  • Identifies all significant diagnoses (complications and co-morbidities/HCCs) relevant to the type of visit and assigned appropriate codes.
  • Codes procedures as appropriate and identifies the principal procedure consistent with established coding guidelines.
  • Ensures all conditions coded adequately reflect the appropriate clinical severity and grouping assignment in accordance with documentation.
  • Follows official coding guidelines and directives and uses reference materials to ensure codes assigned are in compliance with state and federal regulations.
  • Validates accounts for medical necessity based on local medical review policies (LMRPs), national coverage determinations (NCDs), or payer guidelines.
  • Researches and validates claim edits and denials appropriately.
  • Obtains clarification and/or collaborates with the Provider, Clinical Documentation Specialist, and/or Internal Coding Auditor to improve overall quality and completion of clinical documentation in patient records to ensure accurate and complete coding.
  • Applies charge data as appropriate for services provided. Verifies level of service charged is supported by accompanying documentation.
  • Completes coding consistent with established production standards for type of service.
  • Verifies and corrects all abstract data captured.
  • Assists with new hire and current staff training as well as student internship coding training.

Department Specific Duties
  • For hospital services – Codes for 3 or more specialty services (e.g. inpatient, emergency, home health, outpatient surgery, observation).
  • For professional services - Codes 50% of more of time with specialty services (e.g. surgery, hematology/oncology, cardiology) or coordinates special projects/teams (e.g. provider newsletter, denials team).
Knowledge, Skills and Abilities
  • Knowledge of ICD-10-CM/PCS and CPT/HCPCS coding and medical necessity guidelines.
  • Knowledge of various coding groupers used for various payers and types of encounters.
  • Ability to read and interpret medical record documentation including laboratory and pharmacology data.
  • Knowledge of Microsoft Office tools (excel, outlook, word).
  • Strong computer background with basic typing and keyboarding skills.
  • Work prioritization skills needed.
  • Ability to concentrate on detailed tasks for long periods of time.
  • Ability to work independently with frequent interruptions.
  • Excellent interpersonal communication (verbal, non-verbal, and listening) skills and written communication skills.
  • Knowledge of hospital payment systems and federal and state regulations related to billing, coding, and compliance.
Professional Experience
  • Five years previous coding experience required.
  • Associate of Applied Science degree or Bachelor's degree in Health Information Technology or completion of coding certificate program required.
Licensure, Certification, Registration
  • AHIMA or AAPC coding certification (e.g. RHIT, RHIA, CCA, CCS, CCS-P, CPC) is required

Location: Mercy Medical Center - Cedar Rapids · Health Information Management
Schedule: Full Time, Day, flexible

Job ID: 80867

Posted 19 days ago

Share This Job