Job Description

Job Description

Job Description

Job Summary

The Medical Coder is responsible for accurately reviewing patient health records and assigning standardized diagnosis, procedure, and service codes in accordance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS, payer requirements, and organizational policies.

This role supports accurate reimbursement, regulatory compliance, quality reporting, and the overall integrity of health information. The Medical Coder must maintain a high level of accuracy, productivity, confidentiality, and compliance with applicable healthcare standards.

Key Responsibilities

• Assign accurate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with official coding guidelines and regulatory requirements.
• Review clinical documentation to ensure coding accurately reflects diagnoses, procedures, treatments, and services provided.
• Abstract clinical and demographic information from patient records into health information and billing systems.
• Review medical necessity and ensure coding supports appropriate and compliant reimbursement.
• Review physician documentation and query providers when clarification or additional documentation is required.
• Evaluate claims in the Quadax work queue and make appropriate corrections to the medical record and claim.
• Utilize the 3M Coding System to support accurate and compliant coding.
• Assist with denial management by reviewing denied claims and recommending coding corrections when appropriate.
• Participate in internal and external coding audits.
• Maintain a coding accuracy rate of 95% or higher while meeting established productivity and turnaround-time expectations.
• Maintain compliance with HIPAA, CMS regulations, payer requirements, and organizational policies.
• Maintain the confidentiality and security of protected health information (PHI).
• Work closely with Madison Parish Hospital (MPH) providers and other clinical staff regarding coding questions and documentation.
• Maintain current coding knowledge, credentials, and competencies through continuing education.
• Perform other duties as assigned by the HIM Director.

Required Qualifications

• Minimum of 2 years of medical coding experience , or an equivalent combination of education, training, and experience.
• Working knowledge of ICD-10-CM diagnosis coding.
• Knowledge of medical terminology, anatomy, and physiology.
• Basic knowledge of electronic medical records (EHR) systems.
• Ability to interpret clinical documentation and apply appropriate coding guidelines.
• Ability to work independently, prioritize tasks, and meet deadlines and turnaround-time requirements.
• Ability to communicate effectively and work collaboratively with Madison Parish Hospital providers and clinical staff.
• Successful completion of a medical coding, health information management, healthcare administration, or related certification program.

Required Certification

Candidates must hold one of the following certifications :

• CCS
• CCA
• RHIT
• RHIA
• CPC
• CPC-A with appropriate supervision

Education

• High school diploma or equivalent — Required
• Associate degree in Health Information Management or a related field — Preferred

Preferred Skills & Abilities

• Strong knowledge of ICD-10-CM, CPT, HCPCS Level II, and official coding guidelines.
• Familiarity with CMS, OIG, and payer-specific coding requirements.
• Strong attention to detail and commitment to coding accuracy.
• Analytical and critical-thinking skills for interpreting complex clinical documentation.
• Excellent written and verbal communication skills.
• Strong time-management and organizational skills.
• Proficiency with coding software and EHR systems.
• Experience with 3M Coding System and Quadax preferred.
• Ability to consistently maintain a 95% or higher coding accuracy rate .

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