[Hiring] Professional Medical Coder I @Yale New Haven Health

Role Description

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
• Performing other coding related tasks

Responsibilities include:

• 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 clinician charging to accurately select and/or validate the appropriate CPT codes and modifiers in accordance with official coding guidelines, including 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: Bachelor's degree preferred. Requires coursework, 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 communication 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.

Company Description