Medical Coder III

mercycare; United States; On-site; USD 39,000 - 58,000; Full time

Job summary

Mercy Medical Center in Cedar Rapids is seeking a professional coder to support hospital coding and reimbursement processes. This role focuses on accurate ICD-10-CM/PCS and CPT/HCPCS coding for hospital and professional services, ensuring compliance with federal regulations and payer guidelines.

The incumbent will identify all relevant diagnoses and procedures, validate medical necessity, and collaborate with providers and auditors to improve documentation quality. AHIMA/AAPC certs are required.

Qualifications

• Knowledge of ICD-10-CM/PCS and CPT/HCPCS coding and medical necessity guidelines.
• Ability to read and interpret medical record documentation including lab and pharmacology data.
• Experience with payers and coding groupers.
• Proficiency with Microsoft Office tools.
• Three years of coding experience required.
• AHIMA or AAPC coding certification is required.

Responsibilities

• Codes the correct principal/primary diagnosis with high accuracy.
• Identifies all significant diagnoses (HCCs) and assigns appropriate codes.
• Codes procedures and principal procedures as appropriate.
• Ensures coded data reflect clinical severity and proper grouping.
• Follows coding guidelines and payer/LMRP/NCD directives.
• Validates medical necessity and compliance with regulations.
• Researches claim edits and denials; resolves issues.
• Collaborates with providers and documentation specialists to improve records.
• Applies charge data and verifies level of service is supported by documentation.
• Completes coding within established production standards.
• Supports intern coding training and education.
• Codes for assigned hospital areas or specialties.

Skills

ICD-10-CM/PCS coding

CPT/HCPCS coding

Reading medical records

Detail orientation

Independent work

Communication

Education

Associate of Applied Science in Health Information Technology

Coding certificate program

Bachelor's degree in health information technology

Tools

Microsoft Office

Job description

Talent Tuesdays at Mercy Cedar Rapids - Mercy Medical Center

Work Shift

Day

Scheduled Weekly Hours

40

Summary

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 (HCCs) relevant to the type of visit and assigns 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 Specialists, 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 student internship coding training.
• Codes for assigned area(s) within hospital or specialty.
• Coordinates special projects/teams (e.g. provider newsletter, denials teams).
• Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

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 detail tasks for long periods of time.
• Ability to work independently and communicate effectively.

Professional Experience

Three years previous coding experience required.

Education

Associate of Applied Science degree or bachelor's degree in health information technology or completion of coding certificate program preferred.

Licensure, Certification, Registration

AHIMA or AAPC coding certification (e.g. RHIT, RHIA, CCA, CCS, CCS-P, CPC) is required.

Physical Requirements

Sedentary: Exert up to 10 lbs. of force occasionally and/or a minute amount frequently

Pay Rate Type

Hourly

Mercy is an independent, community-based organization supporting the Cedar Rapids area for over 120 years.

Mercy is an equal-opportunity employer. We value diversity, equity, and inclusion and therefore evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status, and other legally protected characteristics.