Coder III

Adirondack Health; Town of Harrietstown (NY); On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

Paid Benefit Time (PTO and Sick days)

Tuition Reimbursement

403(b) Retirement Plan with Employer"s

Job summary

Adirondack Health is seeking a Medical Coding Specialist to perform inpatient, ambulatory surgery, and outpatient coding across AH campus locations. You will code using ICD-10-CM/PCS, CPT-4 and HCPCS, ensuring correct MDC/DRG classifications and applying CCI and medical necessity edits to support clean claims.

Requirements include a high school diploma or equivalent, one professional coding certification (AAPC or AHIMA), and at least seven years of certified coding experience, with strong

Qualifications

• Must hold professional coding certification (AAPC or AHIMA).
• At least seven years of certified medical coding experience.
• Strong knowledge of anatomy, physiology and medical terminology.
• Interpersonal skills to interact with Medical Staff, Administration and Quality Management.

Responsibilities

• Code inpatient, ambulatory surgery, referred outpatient services and professional services per AHG guidelines.
• Review medical records and assign ICD-10-CM/PCS, CPT-4 and HCPCS codes.
• Ensure correct MDC/DRG classification for inpatient records based on payment methodology.
• Apply CCI edits and Medical Necessity edits to improve clean claims submission.

Skills

Medical coding

ICD-10-CM/PCS

CPT/HCPCS coding

Interpersonal skills

Education

High School diploma or equivalent

AAPC or AHIMA certification

Job description

Medical Coding Specialist

Performs coding in accordance with Adirondack Health (AH) approved, CMS, and AMA coding guidelines which includes inpatient, ambulatory surgery, referred outpatient services, professional services for employed or contracted providers at any of the AH campus locations.

Medical records are reviewed and accurately coded with the appropriate ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS, Evaluation and Management codes. All inpatient medical records are classified to the correct MDC/DRG based on the payment methodology for that specific financial class (MS, AP, APR DRGs). Ambulatory Surgery patient records are run through the APC finder for edits and grouped into either the APC or APG.

Correct Coding Initiative (CCI) edits and Medical Necessity edits are generated on all coded cases and the coders "work" these edits to help with clean claims submission.

Educational Requirements/Qualifications:

1. High School diploma or equivalent.
2. At least one professional coding certification (through AAPC or AHIMA) required. A thorough understanding of anatomy and physiology and medical terminology is required.
3. At least seven years of demonstrated certified medical coding experience is required.
4. Work requires a moderate level of interpersonal skills to interact with the Medical Staff, Administration, and Quality Management (quality, risk, CDI, Core Measures).

Job Type: Full-Time

Benefits of Working Full-Time at Adirondack Health:

• Medical, Dental and Vision Insurance
• Paid Benefit Time (PTO and Sick days)
• Tuition Reimbursement
• 403(b) Retirement Plan with Employer Contributions
• And much more

Salary Range: $25.17 - $37.77 per hour