Professional Medical Coder I

Yale New Haven Health; New Haven (CT); On-site; USD 60,000 - 80,000; Full time

Job summary

Yale New Haven Health is seeking a Professional Coder I to conduct comprehensive reviews of medical record documentation and perform coding tasks across multiple specialties. Duties include charge review, coding validation, denial research, and clinician communication to ensure accurate CPT and ICD-10-CM coding.

The role requires at least 2 years of professional coding experience, a CPC or CCS-P credential (AAPC) or equivalent, and strong written and verbal communication abilities.

Qualifications

• Bachelor's degree preferred with coursework in anatomy, physiology, medical terminology, and disease processes.
• Requires minimum 2 years of professional coding experience.
• CPC or CCS-P credential or another AAPC designation required.
• CPC-As are not acceptable at this level.
• Strong communication, critical thinking, and time management skills.

Responsibilities

• Reviews medical record documentation to determine appropriate ICD-10-CM codes for coding reviews.
• Reviews clinician charging to accurately select CPT codes and modifiers per guidelines; resolves edits.
• Maintains a minimum 95% overall coding quality score in diagnostic, procedural, modifier code selection.
• Maintains productivity as defined by the department for coding service line.
• Engages in career development: journals, articles, learning circles, attending coding education sessions.
• Reviews specialty denials and researches needed to resolve.
• Performs other coding related roles as assigned by the department manager.

Skills

Anatomy & physiology knowledge

Medical terminology

ICD-10-CM coding

CPT coding

E/M knowledge

Strong communication skills

Time management

Education

Bachelor's degree preferred

Anatomy & physiology coursework

Medical terminology coursework

Pathophysiology coursework

Disease process coursework

Job description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The Professional Coder I is responsible for a complete review of the medical record documentation and performs a variety of coding related activities for 1 or more specialties. Work may include, but are not limited to: charge review,coding review, prioritizing workload, resolving edits, researching denials, interacting with clinicians verbally and /or in writing, and performing other coding related tasks.

EEO/AA/Disability/Veteran

Responsibilities

• Reviews medical record documentation to determine appropriate ICD-10-CM codes for work identified for a coding review in accordance with official coding guidelines.
• Reviews medical record documentation and reviews clinician charging to accurately select and/or validate the appropriate CPT codes and modifiers in accordance with official coding guidelines. This includes resolving coding edits, as applicable.
• Maintains a minimum of 95% overall coding quality score in work that qualifies for a coding review in diagnostic, procedural, modifier code selection and other applicable fields.
• Maintains the productivity expectations as defined by the department for the coding service line.
• Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions, and actively participates in learning circles
• Reviews specialty specific denials and consults research needed to resolve.
• Completes other coding related roles and responsibilities as assigned by the department manager.

Qualifications

EDUCATION

• Bachelors degree preferred. Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process.

Experience

• Requires a minimum of 2 years of professional coding experience.

LICENSURE

• CPC or CCS-P credential required or another professional coding designation through the Academy of Professional Coders (AAPC). CPC-As are not acceptable in this level of position.

Special Skills

• Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM, and CPT coding with the ability to acclimate and apply knowledge in a fast-paced virtual coding environment.
• Knowledge of professional E/M leveling preferred.
• Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills.
• Must be able to perform functions independently and under limited supervision.

YNHHS Requisition ID

190217