Certified Medical Coder

Responsibilities:

• Review and analyze physician notes, operative reports, discharge summaries, and clinical documentation from hospital and nursing home records.
• Assign accurate ICD-10-CM/PCS, CPT, and HCPCS codes for inpatient, outpatient, and nursing home in accordance with CMS and payer guidelines.
• Ensure coding compliance for Medicare Part A & B, Medicaid, and commercial insurance coding requirements.
• Validate medical necessity, diagnoses, procedures, and supporting documentation to justify coded services.
• Query physicians and clinical staff for documentation clarification when required, following compliant query practices.
• Conduct coding quality reviews and internal audits to ensure adherence to federal, state, and payer-specific regulations.
• Stay current with CMS updates, NCCI edits, LCDs/NCDs, and payer-specific coding policies related to hospital and long-term care services.
• Maintain accurate, complete...