Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. ( 65%)
Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. ( 15%)
Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. ( 10%)
Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. ( 5%)
Performs other duties as assigned or required. (5%)
Requirements
Minimum High School/GED
Successful completion of coding courses in anatomy, physiology and medical terminology
1 year of Hospital and/or Physician Coding
1 year coding at mid-level facilities or clinics
1 year coding major surgeries, observations and/or E/Ms
Medical Terminology
Strong data entry skills
An understanding of computer applications
Ability to work with members of the health care team
Any of the following: Registered Health Information Technician (RHIT), Registered Health Information Associate (RHIA), Certified Coding Specialist Physician (CCS-P), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), CPC-A Certified Professional Coder
Apprentice
Preferred Associate's Degree in Health Information Management or related field