HIM Coder - Hospital Coding Services - PRN
Core
Reviews medical record documentation to assign accurate ICD-10-CM diagnosis, procedure, and CPT codes for hospital services, including dual/single path coding.
Role type
Hospital Medical Coder (IC)
Builds
Accurate medical code assignments for billing and data abstraction
Domain
Healthcare / Medical Coding
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
ICD-10-CM coding, CPT coding, medical terminology, regulatory guidelines, EMR data entry, MS-DRG/APR-DRG assignment, medical necessity documentation
Preferred skills
CCS, CPC, RHIA, RHIT, CCA certifications
Technologies
ICD-10-CM, CPT, EMR, EHR
Responsibilities
Selects and assigns appropriate ICD-10-CM diagnosis, procedure and CPT codes; Ensures appropriate MS-DRG/APR DRG is assigned; Utilizes Electronic Medical Record (EMR) to identify and enter key administrative and clinical data elements; Complies with all legal requirements regarding coding guidelines and policies; Proficient with medical necessity documentation guidelines; Complies with payer specific guidelines for appropriate code assignment; Works coding queues as assigned by manager or designee; Collaborates with Clinical Documentation Improvement (CDI) team for clinical expertise and query opportunities; Submit coding queries to physicians for medical record documentation clarification; Converse with providers or other health care professionals on coding and/or billing practices, if needed; Meets coding productivity and accuracy standards; Continually self-educates on current coding guidelines and regulatory changes
Seniority
Entry to Mid-level, hands-on IC