Job Posting
Medical Coder
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Position Title: Medical Coder
Location: Crittenden Community Hospital
Department: HIM
Employment Type: Full-time
JOB SUMMARY:
Codes hospital discharge records for the purpose of reimbursement, research, and compliance with federal regulations according to diagnoses, operations, and procedures using ICD-10-CM, ICD-10-PCS, HCPCS, and CPT classification systems.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1.Identifies and assigns accurate codes to inpatient hospital discharge records using ICD-10-CM and ICD-10-PCS, ensuring appropriate MS-DRG assignment for reimbursement and reporting.
2.Reviews hospital discharge records for completeness, accuracy, and appropriate documentation prior to final coding and billing, in accordance with standards established by the Director and regulatory agencies.
3.Codes outpatient encounters using ICD-10-CM, HCPCS, and CPT classification systems, ensuring accurate APC assignment for reimbursement and data reporting.
4.Queries providers when documentation is incomplete, unclear, or inconsistent, following compliant query practices.
5.Monitors and follows up on deficient and delinquent records to ensure compliance with Medicare, Medicaid, and hospital policies and timelines.
6.Performs retrospective reviews, audits, and special studies in accordance with organizational and regulatory guidelines.
7.Maintains current knowledge of coding guidelines, reimbursement methodologies, and regulatory updates (CMS, OIG, and other governing bodies).
8.Participates in performance improvement initiatives, including quality audits, denial management, and process optimization.
9.Ensures compliance with HIPAA regulations and maintains strict confidentiality of all patient information.
10.Collaborates with clinical staff, providers, and revenue cycle departments to support accurate documentation and coding practices.
11.Supports the corporate mission: “To provide quality, cost-effective health care in a positive and productive work environment.”
12.Attends all required meetings, in-services, and continuing education to maintain credentials and competency.
13.Performs all duties in accordance with the Corporate Compliance Program, ethical standards, and applicable federal and state regulations.
ADDITIONAL RESPONSIBILITIES:
1.Assists with onboarding and mentoring of new coding staff as needed.
2.Participates in denial resolution and appeals by reviewing coding-related denials and providing supporting documentation.
3.Contributes to departmental policy and procedure development and updates.
4.Performs other duties as assigned.
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION, TRAINING, OR EXPERIENCE:
1.Certified Coding Specialist, Certified Coding Associate, or Certified Professional Coder is preferred.
2.Background in healthcare to include medical terminology, basic anatomy & physiology.
3.High school graduate with to include working knowledge of computer processes, business English, & office procedures.
4.Any knowledge combination of experience & training that provides the preferred knowledge, skills, and abilities.
PHYSICAL DEMANDS:
Work requires prolonged periods of sitting, extensive keyboarding, and continuous use of a computer screen. Frequent visual focus on monitors and repetitive hand and finger movements are necessary. Employees may occasionally lift office supplies, medical records, and other materials, and walk throughout the facility to pick up or drop off records.
WORK ENVIRONMENT:
Work is performed in an adequately lighted and climate- controlled office. For remote work, employees must maintain a secure, private workspace that is isolated from others, free from distractions, and capable of being locked to prevent unauthorized access to confidential information. The work environment must support ergonomic practices, proper lighting, and a HIPAA-compliant handling of electronic and physical records.
EXPOSURE CATEGORY:
Class II exposure category
The specific statements shown in each section of this description are not intended to be all inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Crittenden Community Hospital is an Equal Opportunity Employer.
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