Inpatient Coder

Mohawk Valley Health System; City of Utica (NY); On-site; USD 32,000 - 50,000; Full time

Job summary

Mohawk Valley Health System seeks a Medical Group Coder II to code surgical services across office, outpatient and inpatient settings. You will review records to select HCPCS, CPT and ICD-10-CM codes, while ensuring compliance with CMS and payer guidelines.

Under supervision, you will query providers, educate staff, and assist with denial management. Requires CPC/CCS-P or related certification and at least two years of surgical coding experience.

Qualifications

• Minimum two years surgical-based coding experience.
• Knowledge of EMR, Microsoft Office and email systems.

Responsibilities

• Assign HCPCS/CPT/ICD-10-CM codes for professional services.
• Assign modifiers and review medical necessity and edits.
• Submit queries to providers for unclear documentation.
• Re-submit queries to ensure timely resolution.
• Provide education to staff on documentation and workflow.
• Assist departments with diagnostic and procedural coding.

Skills

Surgical coding experience

EMR knowledge

Microsoft Office

Tools

Epic

3M ICD-10-CM & CPT software

CPT

Job description

Medical Group Coder IIUnder the direct supervision of the Assistant Director of Revenue Cycle Management or Coding Supervisor, the Medical Group Coder will improve documentation, data quality and revenue cycle operations. The coder reviews and analyzes medical records to accurately select all forms of HCPCS service codes (HCPCS, CPT, CPTII, CPTIII) and ICD-10-CM codes for professional services of hospital-based surgical specialty providers. This includes services in the office or other outpatient settings and inpatient settings.

Core Job Responsibilities

• Assign the applicable HCPCS (HCPCS, CPT, CPTII, CPTIII) service codes based on review and analysis of medical records, following CMS, CPT, insurance company, hospital based and office based guidelines.
• Assign applicable modifiers, review medical necessity, CCI and other internal and external coding edits.
• Assign applicable ICD-10-CM diagnosis codes based on knowledge of ICD-10-CM, insurance company, hospital based and office based guidelines.
• Submit queries to providers, clinical staff and managers regarding incomplete, unclear, or inconsistent documentation.
• Re-submit queries as necessary to ensure timely resolution.
• Provide education to providers and clinical staff regarding documentation and work flow opportunities.
• Assist departments with diagnostic and procedural coding.
• Assist Business Office with insurance denials.
• Perform other duties as required.

Education/Experience Requirements

• REQUIRED: Minimum of two years surgical based coding experience or specialty based professional credential Knowledge of EMR, electronic coding resources, Microsoft Office and email systems
• PREFERRED: Completion of specialty based coding coursework or equivalent Knowledge of Epic, 3M ICD-10-CM and CPT software, Vitalware, Microsoft Office, Email systems Knowledge of CMS Teaching Physician Guidelines for Residents and Medical Students 2 years of hospital based, specialty based professional coding experience, or equivalent

Licensure/Certification Requirements

• REQUIRED: CPC, CCS-P, or related AHIMA or AAPC professional specialty certification
• PREFERRED: CPC, CCS-P, or specialty based professional credential

Disclaimer

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability. Successful candidates might be required to undergo a background verification with an external vendor.

Job Details

Req Id 99005 Department MEDICAL GRP ADMIN Shift Days Shift Hours Worked 8.00 FTE 1 Work Schedule HRLY NON-UNION-8 HR Employee Status A1 - Full-Time Union Non-Union Pay Range $23.00 - $36.00 Per Hour