Position Summary

The Medical Coder position is responsible for advancing the functionality and operational efficiency and use of ECW (e-Clinical Works) and ensuring providers are coding correctly. This entails providing medical provider and support staff assistance with the electronic medical record and coding reviews and training for providers.Medical Coderis responsible for reviewing claims for appropriate modifier, gender and age related to CPT codes, New vs. established patient codes for insurance plans and third party payors, under the guidance of regulatory and contractual requirements.

Primary Functions

• Works with users who request access to HIE's and to local hospital provider portals. This involves ensuring correct forms are completed, supporting documents are included and information is sent to the agency. Also works with the users to ensure successful logins and provides password reset support and reactivation of dormant accounts as needed.
• Provides auditing of all new provider notes within 3 months of hire and works with provider if issues are found related to incorrect documentation or insufficient documentation for the code they used.
• Trains new providers on coding requirements for the clinical setting
• Maintains awareness of changes to clinical coding regulations and provides guidance and education to providers regarding these changes.
• Works with clinic managers, site physicians, billing, administration and others to ensure that actions are consistent with SHS-wide objectives, Board policies and administrative procedures. Demonstrates effective and professional interpersonal skills in dealing with support staff, patients, physicians & others.
• Makes good decisions within the scope of responsibilities and implements them effectively.
• Appropriately takes the initiative on some issues / projects, and appropriately seeks advance input / support / approval before proceeding on other issues / projects.
• Contributes positively to SHS-wide objectives and goals, helping with special projects, and assisting others.
• Effective in prioritizing own duties, and dealing with work pressures and demands. Has a reasonable balance between work and personal needs.
• Participates in professional development activities and maintains professional affiliations as indicated.
• HIPAA guidelines for patient confidentiality, and maintains security of Protected Health Information (PHI). Does not exhibit, divulge, copy or remove the contents of any record except to fulfill work assignments
• Performs additional duties as required.

Experience & Qualifications

• High school graduate or G.E.D .required
• Prior experience in ICD-10-CM and CPT-4 coding required
• Two (2) years experience in a coding capacity in healthcare setting highly preferred
• Must have experience working with Microsoft office products and Web based insurance programs.