Job Summary: The ED Facility Medical Coder is responsible for reviewing emergency department documentation and assigning accurate ICD-10-CM, CPT, HCPCS, and facility-level coding based on medical records. The coder ensures compliance with coding guidelines, payer requirements, and regulatory standards while supporting accurate billing and reimbursement.
Key Responsibilities
- Review emergency department medical records for completeness and coding accuracy.
- Assign ICD-10-CM diagnosis codes and CPT/HCPCS procedure codes according to official coding guidelines.
- Determine appropriate Emergency Department facility levels based on documentation and organizational policies.
- Validate physician documentation and identify opportunities for clarification when necessary.
- Ensure compliance with CMS, Medicare, Medicaid, and commercial payer regulations.
- Perform coding audits and quality reviews to maintain coding accuracy standards.
- Resolve coding-related billing edits and denials.
- Maintain productivity and quality metrics as defined by the organization.
- Stay current with coding updates, regulatory changes, and payer policies.
- Collaborate with physicians, clinical staff, CDI teams, and revenue cycle departments.
Required Qualifications
- High school diploma or equivalent; associate's or bachelor's degree preferred.