Medical Records Coder - (Certification) CCS, RHIT, CIC, CPC

DaMar Staffing; Harlingen (TX); On-site; USD 40,000 - 65,000; Full time

Job summary

Palms Behavioral Health is hiring a Medical Records Coder to assign ICD-10-CM/PCS and CPT codes, review patient records, and ensure accurate coding for billing and reporting. This onsite position requires strong terminology knowledge and the ability to resolve discrepancies in charts.

The role involves maintaining confidentiality, collaborating with physicians to obtain missing information, and processing reports to support accurate reimbursement and regulatory compliance.

Qualifications

• Two or more years of medical billing/collections/coding required.
• Working knowledge of coding principles for inpatient and outpatient coding, plus medical terminology.

Responsibilities

• Assign ICD-10-CM/PCS and CPT codes for diagnosis, procedures and services.
• Code claims to obtain reimbursement from insurance or government programs.
• Read and analyze patient records to extract precise information from documentation and reports.
• Request missing diagnoses from physicians when information is incomplete.
• Maintain confidentiality of patient care information and chart contents.
• Inform administrator of any chart incongruities.
• Clarify diagnoses with physicians as needed to ensure accuracy.
• Process physician reports needed to code appropriately and accurately.

Skills

Billing/Coding experience

Coding accuracy

Medical terminology

Education

High school diploma or equivalent

Certificate or Associate's Degree in medical coding or related field

Job description

Medical Records Coder

The Medical Records Coder is responsible for assigning ICD-10-PCS diagnostic and procedural codes to patient accounts codes and abstracts hospital medical records for maintenance of disease indices, internal and external reporting, research, compliance with federal, state and other regulatory agencies, and for billing and reimbursement. Uses various coding manuals and computer encoder. Confirms appropriate DRG assignments. Safeguards and preserves the confidentiality of patient identifiable information in accordance with hospital and department policy. Resolves error reports associated with billing process, identifies and reports error patterns, and, when necessary, assists in design and implementation of workflow changes to reduce billing errors.

Essential Functions:

• Assigns appropriate codes using International Classification of Disease system (ICD-10) and/or Current Procedural Terminology (CPT) for diagnosis, procedures, and services.
• Correctly codes claims based on the services a patient receives in order to obtain reimbursement from insurance or government healthcare programs.
• Reads and analyzes patient records, extracting precise information from documentation, test results and reports.
• Requests diagnosis from physicians when not recorded on discharge and in cases where information is incomplete.
• Maintains confidentiality regarding patient care information and chart contents.
• Informs administrator of any incongruences noted in the chart record.
• Clarifies diagnosis, conditions, and treatment information by working with the physician according to company policy and procedure as needed
• Processes physician reports needed to code appropriately and accurately.

Education/Experience/Skill Requirements:

• High school diploma or equivalent required. Certificate or Associate's Degree in medical coding or related field preferred.
• Two or more years' of medical billing/collections/coding required.
• Ability to crossover between all coding types and maintain a coding accuracy.
• A working knowledge of coding principles as it applies to both inpatient and outpatient coding and background in medical terminology, pathophysiology, anatomy & physiology.

Licenses/Designations/Certifications:

CCS, RHIT or approved Medical Coding Certificate required.

Work Location:

This position is onsite at the facility and is not a remote position.

Supervisory Requirements:

This position is an Individual Contributor.

Why Palms Behavioral Health? Palms Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Palms Behavioral Health is an EOE.

Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.