Medical Coder II Requirements and Responsibilities
Essential Functions
- Code hospital-based professional services accurately and on time, including outpatient or inpatient hospital services, single services, and complete inpatient stays.
- Review medical record documentation to assign and sequence diagnosis and procedure codes in accordance with coding guidelines.
- Enter appropriate diagnosis codes, professional service codes, modifiers, and facility service or charge codes into the electronic system.
- Assign and record appropriate modifiers, including GC, NO, or NDU, in accordance with Teaching Physician Rules.
- Maintain current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes for unlisted or unusual procedures, and Medicare, Medicaid, TRICARE, commercial, and managed care regulations.
- Stay informed through professional literature, workshops, and lectures.
- Complete sufficient continuing education hours to maintain national coding certification.
- Serve as a resource for less experienced medical coders.
- Collaborate with team members, Corporate Revenue Cycle, and Compliance Analysts to answer questions and resolve documentation, coding, and billing issues involving professional or facility services.
- Educate physicians to support documentation that enables the greatest possible coding accuracy.
- Resolve pending charges and claim denials in WakeOne coding work queues.
- Perform other related duties incidental to the work described.
Skills and Qualifications
- Experience coding physician professional services in a teaching environment.
- Familiarity with Medicare Teaching Physician Rules.
- Familiarity with facility fee services within a provider-based clinic.
- Ability to meet and maintain department-defined Level II Coder quality and productivity standards.
Education and Experience
- High school diploma or GED equivalent.
- Two years of medical coding experience in a similar environment; or
- Eligibility for internal promotion after achieving and maintaining department-defined Coder Level II performance criteria for six consecutive months.
Licensure, Certification, and Registration
- Active national coding certification: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
Work Environment
- Clean, well-lit, and comfortable environment.
- Quiet work area.
Physical Requirements
- Activities may include standing, walking, sitting, bending, reaching with the arms, using finger and hand dexterity, talking, hearing, and seeing.
- May involve lifting, carrying, pushing, or pulling items with listed maximum weights of 20 pounds, 50 pounds, or 100 pounds, as applicable to the role.
- The source frequency table does not clearly identify the percentage assigned to each activity; confirm the applicable frequency and lifting category with the department.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.