Coder

Coder Overview

• The Coder role is a contract position focused on professional fee coding and auditing, ensuring compliance with official coding guidelines and accuracy in claim submissions.
• Collaborate with the Revenue Cycle Management team to validate patient demographics, insurance details, and financial classifications for accurate claim processing.
• Utilize expertise in renal specialty coding, risk adjustment, and E&M coding to ensure precise code assignments and audits.
• Prepare physician inquiries and feedback, crafting compliant and provider-friendly verbiage to enhance coding accuracy and communication.
• Maintain a high coding production rate and accuracy, adhering to a 95% or above benchmark for both metrics.
• Conduct claim editing, troubleshoot account issues, and perform root cause analysis to resolve coding discrepancies effectively.
• Work remotely with a minimum internet speed requirement, ensuring seamless connectivity and productivity.

Coder Key Responsibilities & Duties

• Analyze and review medical records to assign accurate diagnosis and procedure codes.
• Code professional fee charts and validate clinical code assignments as per market requirements.
• Prepare daily coding logs, track production independently, and meet performance benchmarks.
• Compose physician-friendly feedback for code validation audits and other reviews.
• Demonstrate proficiency in ICD-10 and CPT coding systems, maintaining high accuracy standards.
• Conduct claim editing activities, troubleshoot issues, and escalate to leadership as necessary.
• Utilize Microsoft Office applications to support coding and auditing tasks effectively.

Coder Job Requirements

• High School Diploma or GED is required; additional certifications are preferred.
• Minimum of 3 years of coding experience, with 5 years preferred.
• Approved credential from AHIMA or AAPC, such as Certified Professional Coder.
• Expertise in risk adjustment coding and HCC certification is advantageous.
• Proficiency in Microsoft Office applications and familiarity with remote work environments.
• Strong analytical skills and the ability to work independently in a remote setting.
• Experience in renal care or value-based care environments is a plus.