Medical Group Coder II (UTICA, NY, US, 13502)

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 to improve documentation, data quality, and revenue cycle operations across hospital-based surgical specialty services. You will review records to select HCPCS, CPT, CPTII, CPTIII, and ICD-10-CM codes for outpatient and inpatient settings.

Responsibilities include coding reviews, provider queries, education for staff, and supporting denial management. Requires coding credentials and experience in surgical coding, with familiarity in Epic or

Qualifications

• Minimum of two years surgical-based coding experience or specialty-based professional credential.
• Knowledge of EMR, electronic coding resources, Microsoft Office and email systems.

Responsibilities

• Assign HCPCS/CPT/CPTII/CPTIII service codes based on medical records per guidelines.
• Assign modifiers, review medical necessity and coding edits.
• Assign ICD-10-CM diagnosis codes per guidelines.

Skills

Surgical coding experience

Provider communication

Education

Specialty-based coding coursework

Tools

Epic

3M ICD-10-CM/CPT software

Vitalware

Microsoft Office

Email systems

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 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, 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

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