Review medical records for outpatient or same day surgical procedures
Assign appropriate diagnostic and procedural codes (CPT and ICD-10)
Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding
Submit necessary provider queries to resolve documentation discrepancies
Perform quality assessment of records, including verification of medical record documentation
Review appropriate charges and make changes or recommendations based on the documentation
Research errors or missing documentation from medical records to provide accurate coding processes
Abstracts and assigns the appropriate ICD-10-CM and CPT codes for all diagnoses and procedures

AHIMA/AAPC Credentials
Five or more years of Auditing experience
Physician surgery coding experience preferred
Must have facility outpatient surgery and observation experience
Must be able to pass a coding assessment
Must be proficient in Microsoft Office, including Outlook, Excel, and Teams
Ability to multi-task and have excellent communication skills
Must meet and maintain a 95% quality accuracy rate and productivity standards
Must be able to apply official coding guidelines, NCCI edits, CPT Assistants, and Coding Clinics.
Must have experience working in a remote environment.

Coder, SDS

Key skills