Medical coder

Description

• Review emergency department medical records to assign accurate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, and applicable modifiers.
• Accurately assign facility Evaluation and Management (E/M) levels in accordance with client-specific emergency department leveling guidelines and facility charging methodologies, including knowledge of the ACEP tool.
• Analyze documentation from nursing staff, physicians, ancillary departments, and diagnostic services to ensure complete code assignment and charge capture.
• Apply official coding guidelines, CMS regulations, National Correct Coding Initiative (NCCI) edits, and payer-specific requirements.
• Review accounts for appropriate assignment of procedural services and injections/infusions when applicable.
• Identify documentation deficiencies and communicate within the appropriate channels regarding coding clarification needs.
• Maintain compliance with Medicare, Medicaid, commercial payer, and organizational coding policies.
• Participate in coding quality reviews, audits, educational initiatives, and process improvement activities.
• Remain current on coding updates, reimbursement changes, and regulatory requirements affecting emergency department facility coding.
• Collaborate with coding leadership, auditors, and client representatives to resolve coding-related issues.

Additional Skills & Qualifications

• Review emergency department medical records to assign accurate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, and applicable modifiers.
• Accurately assign facility Evaluation and Management (E/M) levels in accordance with client-specific emergency department leveling guidelines and facility charging methodologies, including knowledge of the ACEP tool.
• Analyze documentation from nursing staff, physicians, ancillary departments, and diagnostic services to ensure complete code assignment and charge capture.
• Apply official coding guidelines, CMS regulations, National Correct Coding Initiative (NCCI) edits, and payer-specific requirements.
• Review accounts for appropriate assignment of procedural services and injections/infusions when applicable.
• Identify documentation deficiencies and communicate within the appropriate channels regarding coding clarification needs.
• Maintain compliance with Medicare, Medicaid, commercial payer, and organizational coding policies.
• Participate in coding quality reviews, audits, educational initiatives, and process improvement activities.
• Remain current on coding updates, reimbursement changes, and regulatory requirements affecting emergency department facility coding.
• Collaborate with coding leadership, auditors, and client representatives to resolve coding-related issues.