Medical Group Coder I

Mohawk Valley Health Systems; City of Utica (NY); On-site; USD 31,000 - 47,000; Full time

Job summary

Mohawk Valley Health Systems is seeking a Medical Group Coder to enhance documentation quality and revenue cycle operations. Under supervision, you will review medical records to select HCPCS, CPT, CPTII, CPTIII and ICD-10-CM codes for professional services in outpatient and inpatient settings.

Responsibilities include assigning codes, modifiers, and diagnoses, querying providers for unclear data, and educating staff on documentation and workflow.

Qualifications

• Knowledge of EMR, electronic coding resources, Microsoft Office and email systems.
• Minimum of completed professional coding coursework.
• Knowledge of CMS Teaching Physician Guidelines for Residents and Medical Students.
• 2 years of hospital-based professional coding experience.

Responsibilities

• Assign HCPCS service codes based on medical records and guidelines.
• Assign modifiers, review medical necessity and coding edits.
• Assign ICD-10-CM diagnosis codes per guidelines.
• Submit queries to providers for unclear documentation and follow up.
• Provide education to providers and clinical staff on documentation and workflow.
• Assist departments with diagnostic and procedural coding.
• Assist Business Office with insurance denials.
• Perform other duties as required.

Tools

Epic

3M ICD-10-CM/CPT

Vitalware

Microsoft Office

Job description

Job Summary

Under 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 primary care, psychiatric and other non-inpatient surgical 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:

• Knowledge of EMR, electronic coding resources, Microsoft Office and email systems

PREFERRED:

• Minimum of completed professional coding coursework
• 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 professional coding experience

Licensure/Certification Requirements

REQUIRED:

• CPC, CCS-P, or related AHIMA or AAPC professional certification

PREFERRED:

• CPC, CCS-P or related AHIMA or AAPC professional certification

Disclaimer

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, 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 99206

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 $22.69 - $34.43 - Per Hour