Outpatient Professional Coder - Full time - Detroit

Populance; Detroit (MI); On-site; USD 60,000 - 80,000; Full time

Job summary

AAPC is seeking a medical coder to review patient records, abstract data for reimbursement, and ensure coding compliance. The role involves assigning ICD-9-CM and CPT codes, using encoder software, and verifying documentation for accurate billing.

Strong knowledge of anatomy and coding systems is required. The position emphasizes attention to detail, collaboration with medical staff, and adherence to federal/state regulations.

Qualifications

• High School Diploma or GED is required.
• Some college or coursework in Accounting, Business, Healthcare Administration or Medical Record Sciences is preferred.
• Must have thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
• Six months previous coding experience is preferred, but not required.

Responsibilities

• Identifies all diagnostic and operative procedures for coding by reviewing the patient's medical record.
• Analyzes provider documentation to assign or verify the appropriate CPT code.
• Verifies and/or requests documentation to support compliance.
• Assigns diagnostic and procedural codes using encoder software.
• Reviews charges and assigns appropriate facility E/M level when applicable.
• Maintains knowledge of coding guidelines and reimbursement policies.

Education

High School Diploma or GED

Some college or coursework in Accounting, Business, Healthcare Administration or Medical Record Sciences

Anatomy, physiology, pathophysiology knowledge

Job description

Job Title

Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

Principal duties and responsibilities:

• Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient's medical record.
• May analyze provider documentation to assign or verify the appropriate Evaluation & Management (E&M) CPT code.
• Verifies and/or requests documentation to support compliance.
• Assigns diagnostic and procedural codes in accordance with coding principals and established guidelines, utilizing encoder software.
• Reviews charges, assign charges and assigns appropriate facility E/M level, when applicable.
• Utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-9-CM diagnoses and ICD-9-CM/CPT procedures.
• Verifies completeness of medical record within electronic medical record, reporting any discrepancies to supervisor.
• Interacts with medical staff for clarification of documentation.
• May review daily system-generated error reports to correct or complete missing data elements.
• May review and correct coding errors, edits, rejections and/or disputes.
• If participating in the remote coding program, required to adhere to the Remote Coding Program Policy (Medical Record Services Policy 09).
• Maintains a working knowledge of applicable Federal, State and local laws and regulations, the Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
• Performs other related duties as required.

Education/experience required:

• High School Diploma or G.E.D. equivalent required.
• Some college or additional coursework in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred.
• Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. Six (6) months prior coding experience preferred, but not required.

Certifications/Licensures required:

• Certification as a Registered Health Information Technician (RHIT), RHIT Certification eligibility, or CPC, CPC-A, CCS, CCP or CCA certification required.

Physical demands/working conditions:

Normal office environment with minimal exposure to noise, dust, or extreme temperatures.