Medical Coder
Lake Region Healthcare
Fergus Falls, MN
2017 - Current
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Verified accuracy of procedure codes to ensure proper reimbursement levels.
- Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
- Maintained up-to-date knowledge of coding changes, updates, and new rules.
- Performed audits on coded claims to ensure that all required data elements are included for accurate payment processing.
- Identified opportunities for process improvements related to medical coding operations processes and procedures.
- Collaborated with other departments such as billing, clinical documentation improvement, quality assurance to ensure accurate coding practices are being followed.
- Validated accuracy of diagnosis codes as well as modifiers used on claims before final submission to payer and insurance companies.
- Ensured timely resolution of denials due to incorrect code assignments or missing information in the claim form.
- Participated in meetings with physicians, nurses, case managers and other healthcare professionals in order to discuss complex cases or clarify documentation requirements.
- Analyzed data from various sources including electronic health records databases, insurance websites, in order to identify potential errors in the coded data sets.
- Provided feedback on best practice approaches for improving efficiency during the medical coding process.
- Created detailed reports highlighting areas of improvement or potential risk associated with certain types of claims.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained high accuracy rate on daily production of completed reviews.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Safeguarded medical records to maintain patient confidentiality.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Compiled and coded patient data using standard classification systems.
- Maintained positive working relationship with fellow staff and management.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
