Medical Coder III

Mercy Medical Center; United States; On-site; USD 30,000 - 55,000; Full time

Job summary

Mercy Medical Center is seeking a remote Medical Coder experienced in ICD-10-CM/PCS and CPT/HCPCS coding. The role supports hospital and professional services coding for reimbursement, research, and statistics in compliance with federal regulations.

Three years of coding experience are required. AAS or BA in health information technology or a coding certificate is preferred, with AHIMA/AAPC certifications highly desirable. This is a remote, hourly wage position with standard 40-hour weeks.

Qualifications

• Knowledge of ICD-10-CM/PCS and CPT/HCPCS coding guidelines.
• Experience with identifying and coding diagnoses and procedures.
• Ability to determine medical necessity based on guidelines and payer policies.
• Strong attention to detail and ability to work independently.
• Proficiency with basic office software and data entry.

Responsibilities

• Codes the principal/primary diagnosis with 95%+ accuracy.
• Identifies all significant diagnoses (HCCs) for visits.
• Codes procedures and principal procedures per guidelines.
• Ensures codes reflect clinical severity and proper grouping.
• Follows coding guidelines to ensure compliance with regulations.
• Validates medical necessity and adheres to payer policies.
• Researches claim edits and denials; collaborates for resolution.
• Assists with training and mentoring interns or junior coders.
• Applies charge data and verifies level of service against documentation.
• Coordinates with team on special projects and denials management.

Skills

ICD-10-CM/PCS

CPT/HCPCS

Medical terminology

Reading medical records

MS Office

Education

Associate of Applied Science in Health Information Technology

Coding certificate program completed (preferred)

Tools

Microsoft Office

Job description

Job Location

Remote Work: We are building a remote team of billers and coders. Work-from-home opportunities available.

Job Description

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

Employment Terms

Work Shift Day: Scheduled, Weekly Hours 40

Employer Information

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

Equal Opportunity Statement

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.

Talent Tuesdays

An open-house hiring event, every Tuesday.