Medical Coding Specialist
A Medical Coding Specialist is responsible for translating healthcare diagnoses, procedures, medical services, and equipment into universal medical alphanumeric codes.
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Sample Job Descriptions for Medical Coding Specialist
Below are the some sample job descriptions for the different experience levels, where you can find the summary of the role, required skills, qualifications, and responsibilities.
Junior (0-2 years of experience)
Summary of the Role
Seeking a detail-oriented and organized Medical Coding Specialist to convert patient information into standardized codes for insurance and billing purposes. The ideal candidate will be responsible for ensuring the accuracy of medical documentation and adhering to coding guidelines and regulations.
Required Skills
- Strong written and verbal communication skills.
- Proficiency with electronic health record (EHR) systems and medical coding software.
- Time management and organizational skills.
- Critical thinking and problem-solving abilities.
- Basic computer skills and data entry experience.
Qualifications
- Associate's degree or Certificate in Medical Coding, or related field preferred.
- Knowledge of ICD-10, CPT, and HCPCS coding systems.
- Understanding of medical terminology, anatomy, and physiology.
- Attention to detail and analytical skills.
- Ability to maintain confidentiality of patient information.
Responsibilities
- Review patients' records and assign accurate medical codes for diagnoses and treatments.
- Ensure compliance with established coding guidelines and regulations set by organizations such as the AMA and CMS.
- Work closely with healthcare professionals to clarify any ambiguous or incomplete patient information.
- Maintain patient confidentiality and adhere to HIPAA regulations.
- Participate in ongoing education to stay updated on the latest coding procedures and standards.
- Utilize specialized medical coding software to input codes and patient information efficiently.
Intermediate (2-5 years of experience)
Summary of the Role
We are seeking a reliable and detail-oriented Medical Coding Specialist to join our team at a dynamic healthcare facility. This individual will be responsible for accurately coding medical diagnoses and procedures using standardized classification systems. The ideal candidate will have a strong foundation in medical terminology and be thoroughly familiar with coding guidelines and regulations. This position requires an ability to work independently and as part of a team to ensure the highest levels of accuracy and compliance.
Required Skills
- Attention to detail and the ability to identify and resolve discrepancies.
- Critical thinking and strong analytical skills.
- Effective communication and interpersonal skills.
- Proficient with medical software and technology.
- Time management skills and the ability to meet tight deadlines.
- Commitment to continued education and professional development.
- Ability to maintain confidentiality and demonstrate ethical conduct.
Qualifications
- Associate's or Bachelor's degree in Health Information Management or a related field.
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification preferred.
- 2-5 years of coding experience in a healthcare setting.
- Proficiency with ICD-10-CM and CPT coding systems.
- Strong understanding of medical terminology, anatomy, and physiology.
- Experience with electronic health records (EHR) and medical billing systems.
- Knowledge of relevant laws, regulations, and compliance requirements.
Responsibilities
- Review patient medical records and assign codes to diagnoses and procedures performed.
- Ensure codes are accurately assigned and sequenced in accordance with government and insurance regulations.
- Collaborate with healthcare providers to verify necessary information and documentation for proper coding.
- Stay updated on coding guidelines and reimbursement reporting requirements.
- Provide support with audits and regulatory compliance reviews.
- Use specialized medical coding software to enter and validate coding data.
- Collaborate with billing department to ensure all billed services are captured and coded properly.
- Maintain patient confidentiality and adhere to HIPAA guidelines.
Senior (5+ years of experience)
Summary of the Role
We are seeking a dedicated Senior Medical Coding Specialist with over 5 years of experience in various healthcare settings. The ideal candidate must possess a deep understanding of the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes, and have a proven track record of accurate and efficient medical code application.
Required Skills
- Expertise in ICD-10-CM and CPT coding systems.
- Familiarity with medical billing software and electronic health records (EHR) systems.
- Strong analytical skills with attention to detail.
- Excellent communication skills, both verbal and written.
- Ability to educate and advise healthcare staff on coding practices and compliance issues.
- Leadership skills to guide and support junior staff.
Qualifications
- Bachelor's degree in Health Information Management, Nursing, or related field.
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential.
- Minimum of 5 years of medical coding experience in a healthcare setting.
- Experience in specialized medical areas such as oncology, cardiology, or outpatient services is highly desired.
- Extensive knowledge of medical terminology, anatomy, physiology, and disease processes.
- Proven record of high accuracy and efficiency in code assignment.
Responsibilities
- Review and analyze clinical statements to assign standard codes using ICD and CPT.
- Ensure that all healthcare services provided are accurately reflected in the medical records and billing systems.
- Work closely with healthcare providers to clarify information, obtain additional information, or advise them regarding the implications of the codes assigned.
- Stay informed of the latest updates and changes in healthcare coding standards and regulations.
- Perform regular audits to ensure compliance with federal regulations and to avoid fraudulent or incorrect billing.
- Mentor junior coding specialists by sharing knowledge, best practices, and providing guidance as needed.
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