We are seeking a detail-oriented and knowledgeable Medical Coder Analyst to join our healthcare team. The ideal candidate will be responsible for accurately coding medical records, ensuring compliance with industry standards, and supporting the billing and reimbursement processes. This role requires a strong understanding of ICD-10-CM, CPT and HCPCS coding guidelines, rules and regulations with knowledge of basic anatomy and physiology. The Medical Coder Analyst plays a vital role in maintaining the integrity of medical documentation and optimizing revenue cycle management. Candidates with prior experience in medical office settings and proficiency with EMR/EHR systems are highly preferred. Seeking Certified Medical Coder with at least one to two years experience.
Responsibilities
- Analyze provider documentation for diagnosis, procedures, modifier, date of service and place of service following billing and coding guidelines.
- Code and/or validates all outpatient service areas, Diagnosis, E&M and Modifiers meeting productivity levels of 90-100 charts per day. Not limited to number of transactions filed.
- Review assigned work-queues charts to ensure all CPT and/or HCPCS charge codes are accurate based on physician documentation.
- Reviews and keeps updated with all physician billing and coding guidelines.
- Assists physician in assigning CPT codes that represent treatment provided.
- Full knowledge of Coding guidelines: New vs Established vs Aftercare
- Full knowledge of National Correct Coding Initiative (NCCI) to review and resolve NCCI edits for Part B physician billing Claim Edits.
- Maintains confidentiality of patient information as per office practice policy
- Collaborate with healthcare providers to clarify documentation discrepancies or ambiguities.
- Assist in medical record audits to ensure proper documentation and coding accuracy.
- Support medical collections efforts by providing necessary documentation for claims processing and appeals.
- Utilize EMR/EHR systems efficiently to retrieve, review, and document patient information.
- Maintain confidentiality of patient records while adhering to HIPAA regulations.
- Performs other incidental and related duties as required and assigned.
Education and Work Experience
- High School Diploma or General Education Degree (GED)
- College Preferred
- Preferred two-three years of experience
Required Licenses/Certifications:
- Certified Professional Coder (CPC) or
- Certified Coding Specialist (CCS) or
- Certified Coding Specialist Physicians (CCSP)
Skills and knowledge:
- Knowledge of proper application of ICD-10-CM, CPT and HCPCS coding guidelines, rules and regulations with knowledge of basic medical terminology, anatomy and physiology
- Orthopedic coding & billing experience a plus
- Computer proficiency in MS Office (Word, Excel)
- Ability to work under normal supervision performing duties in an area where procedures are standardized but independent decisions required
- Excellent written and verbal communication skills
- Knowledge of billing guidelines
- Ability to work with all employment levels in a collaborative manner including physicians
- Ability to multitask
- Experience working with EMR/EHR systems is highly desirable.
- Prior experience in a medical office environment or healthcare setting is preferred.
- Excellent attention to detail, organizational skills, and ability to interpret complex medical documentation.
FULL TIME , Hybrid- 3 days a week Rockville Centre OR Plainview.
