Job Summary:
The Medical Coder is responsible for ensuring accurate and timely assignment of ICD-10-CM/PCS, CPT, or HCPCS codes for diagnoses and procedures in compliance with federal, state, and hospital regulations. This role plays a vital part in maintaining accurate administrative and clinical data, supporting TMCH’s management planning, and ensuring proper reimbursement for services rendered.
Key Responsibilities:
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Assign appropriate ICD-10-CM, ICD-10-PCS, CPT, or HCPCS codes to all diagnoses and procedures based on medical record documentation.
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Code inpatient and/or outpatient records with precision and consistency following official coding guidelines.
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Utilize coding software and systems such as 3M 360, CAC (Computer Assisted Coding), and Epic for accurate code assignment.
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Review documentation for completeness; request clarification from providers when needed to ensure correct coding and reimbursement.
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Assist physicians, clinical staff, and administrative personnel with DRG/APC and coding-related questions.
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Determine correct sequencing of diagnoses per UHDDS (Uniform Hospital Discharge Data Set) standards.
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Abstract and input coded data for submission to regulatory agencies, third-party payers, and internal teams.
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Maintain a minimum of 95% coding accuracy and meet weekly productivity targets.
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Stay current with updates to coding conventions, DRG/APC methodologies, and hospital policies.
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Review payer-returned charts and address coding challenges promptly.
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Adhere to TMCH’s policies regarding safety, confidentiality, and ethical standards.
Minimum Qualifications:
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Education: High school diploma or equivalent required; completion of a two-year program in Health Information Management preferred.
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Experience: Minimum of 3 years of acute care hospital coding experience.
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Certification: One of the following is required — RHIT, RHIA, CCS, CCS-P, CPC, CIC, or COC.
Knowledge, Skills, and Abilities:
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Proficient in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding principles.
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Strong knowledge of DRG payment methodologies (MS-DRG and APR-DRG) and APC reimbursement models.
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Excellent command of medical terminology and coding guidelines.
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Strong attention to detail, time management, and organizational skills.
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Ability to interpret medical records, regulatory documents, and professional literature.
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Effective written and verbal communication skills.
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Capable of multitasking under strict deadlines and maintaining positive working relationships with hospital staff.
Why Join TMCH:
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Work in a respected healthcare institution that values precision and integrity.
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Contribute to the accuracy of medical data and financial operations.
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Collaborate with professionals dedicated to quality patient care and compliance.
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Continuous learning and professional growth opportunities.