Medical Coder

Roles and responsibilities

Responsible to review patient medical records and assigns codes to diagnoses and procedures performed so HMG can fix insurance as well as patient.

Key Responsibilities / Accountabilities

• Provide quality review and analysis of a wide range of patient medical records and ensure accuracy of coding and maintain records in accordance with accepted medical and legal standards.
• Translate medical information from patient records in hospitals, into alphanumeric codes.
• Translate details from a patient's medical documents, such as physician's notes, lab reports, procedures, and diagnoses into universal medical codes to maintain accurate medical records. Healthcare providers and insurance companies use these standardized codes for billing and record-keeping.
• Make sure that codes are sequenced according to government and insurance regulations.
• Ensure all medical records are filed and processed correctly.
• Aanalyse patient discharge records to match codes to disease, injuries or medical procedures.
• Consult with clinical staff, such as doctors, to verify discharge records.
• keep up to date with health classification codes and coding software.
• Complies with the standards laid down by the Joint Commission International Accreditation (JCIA) / Central Board for Accreditation of Healthcare Institutions (CBAHI).
• Participate in person-centered care initiatives undertaken by HMG.
• Enrich patient experience with compassion, respect and dignity.
• Performs other applicable tasks assigned within the level of his/her competence as required by the immediate supervisor.

Desired candidate profile

Education/ Professional Qualification

Diploma / High School.
Any discipline, preferably in Medical Record Science.

Experience

At least 2 years’ experience in the same field.
Technical Expertise:
Deep knowledge of ICD-10-CM, CPT, and HCPCS Level II coding systems and the ability to apply them accurately.
Proficient in coding medical diagnoses, procedures, and services for accurate insurance billing and reimbursement.
Knowledge of modifiers and how they impact coding and billing.
Attention to Detail:
High level of accuracy in coding medical records and ensuring compliance with healthcare regulations.
Ability to spot discrepancies and address issues before claims are submitted to insurance companies.
Analytical Skills:
Ability to analyze patient records, physician notes, and diagnostic reports to identify the appropriate codes.
Strong problem-solving skills when dealing with complex or unusual coding situations.
Regulatory Knowledge:
Up-to-date understanding of medical coding guidelines, healthcare laws (e.g., HIPAA), and insurance requirements.
Familiarity with payer policies, including Medicare and Medicaid guidelines, and commercial insurance standards.
Communication Skills:
Ability to communicate effectively with physicians, healthcare providers, and billing staff to clarify documentation and resolve discrepancies.
Comfortable explaining coding issues to non-coding staff or assisting with claim-related inquiries.
Time Management:
Ability to manage multiple coding tasks, meet deadlines, and prioritize work in a fast-paced environment.
Technological Proficiency:
Proficient in using coding software, billing systems, and electronic health record (EHR) systems.
Familiarity with medical terminology and clinical procedures.