The Medical Coder is responsible for reviewing clinical documentation and accurately assigning CPT, HCPCS, and ICD-10 codes in compliance with payer regulations and coding guidelines. The role ensures proper reimbursement, reduces denials, and maintains audit readiness.
JOB OBJECTIVE:
Core Responsibilities (Medical Coder)
- Review patient medical records and provider documentation.
- Assign accurate:
- CPT codes
- HCPCS codes
- ICD-10 diagnosis codes
- Apply appropriate modifiers (25, 59, 26, 76, 77, 57, etc.).
- Ensure correct E/M level selection based on 2021 AMA guidelines.
- Validate medical necessity.
- Review NCCI edits and bundling rules.
- Flag documentation gaps to providers.
- Ensure compliance with payer-specific policies.
- Meet daily coding productivity targets.
- Maintain HIPAA compliance.
- 2 years of experience in surgery