What does a Medical Coder do?

The Medical Coder is essential in ensuring accurate and efficient coding of medical records for billing and insurance purposes. This role supports healthcare operations by translating patient information into standardized codes, facilitating smooth reimbursement processes.

What are the Key Responsibilities of Medical Coder?

  • Review patient medical records to assign appropriate codes.
  • Ensure compliance with coding guidelines and regulations.
  • Collaborate with healthcare providers to clarify diagnoses or procedures.
  • Maintain up-to-date knowledge of coding standards (ICD-10, CPT).
  • Assist in resolving billing discrepancies related to coding errors.
  • Participate in audits to ensure accuracy of coded data.

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What are the Skills and Requirements for a Medical Coder?

  • Proficiency in ICD-10, CPT, and HCPCS coding systems.
  • Strong attention to detail and analytical skills.
  • Excellent communication skills for interacting with healthcare professionals.
  • Ability to work independently and manage time effectively.

What are the KPIs to track for Medical Coder?

The performance of the Medical Coder is evaluated based on accuracy rates of coded data, timeliness in processing records, adherence to compliance standards, and contribution towards minimizing claim denials due to coding errors.
Coding Accuracy
Maintain high accuracy rate in assigned codes.
Timeliness
Process medical records within designated timeframes.
Compliance Adherence
Ensure all codes meet regulatory requirements
Reports to
Health Information Manager
Collaborates with
Billing Department, Healthcare Providers
Leads

Are any specific tools or software required for the Medical Coder role?

  • 3M Encoder Software
  • Epic Systems EHR

What is the qualification of Medical Coder?

Certification as a Certified Professional Coder (CPC) or equivalent; 2-3 years experience in a similar role preferred.