Medical Coder

Job ID: J125197
Company: Highmark Inc
Location: Wilkes-Barre, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Aug 10, 2018

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Description

JOB SUMMARY

This job assigns codes (ICD-9, 10, CPT and HCPCS) which most accurately describe diagnosis, procedures and therapies according to established guidelines. The incumbent assigns and sequences ICD-9 CM/CPT/HCPCS and ICD-10 codes to diagnoses and procedure for the documented information.

ESSENTIAL RESPONSIBILITIES

  • Compile, abstract and maintain patient medical records to document condition and treatment. Actively code diagnoses (ICD-9) based on medical record documentation.
  • Review records for completeness, accuracy and compliance with regulations.  Protect the security of medical records to ensure that confidentiality is maintained.
  • Participate in inter-rater reliability testing/peer review exercises, as requested.
  • Other duties as assigned or requested.

EDUCATION

Required

  • Associate's Degree and 1 - 2 years of Coding experience

Substitutions

  • 3 - 5 years of Medical Coding experience in a professional, hospital or insurance selling in lieu of a degree

Preferred

  • None

EXPERIENCE

Required

  • Experience with commercial claims and/or medical/surgical products or Medicare advantage or Medicare fee for service program coverage
  • Experience with the Common Procedure Coding System (HCPCS)
  • Experience with International Classification of Diseases (ICD-9, ICD-10) information

Preferred

  • Experience in working in a healthcare insurance environment
  • Experience in claims

LICENSES AND CERTIFICATIONS

Required (One of the following)

  • Registered Health Information Administrator (RHIA)
  • Registered Health Information Technician (RHIT)
  • Certified Coding Specialist (CCS)
  • Certified Professional Coder (CPC)

Preferred

  • None

SKILLS 

  • Knowledge of coding International Classification of Diseases, 9th Revision (ICD-9) codes
  • Understands and applies appropriate Centers for Medicare & Medicaid Services (CMS) guidelines to coding 
  • Knowledge of anatomy, physiology and medical terminology
  • Coding software familiarity
  • Excellent verbal, math and written communication skills
  • Data entry

SCOPE OF RESPONSIBILITY 

Does this role supervise/manage other employees?

No          

WORK ENVIRONMENT

Is Travel Required?

No   

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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