Ed Professional Coder

Full Time
- India
- Posted 4 hours ago

HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients. At HealthRecon Connect, day after day, we not only hold ourselves accountable for setting and maintaining high standards, but we also passionately strive for the highest achievement, customer delight and thrive on the challenge of high expectations and commitment to excel.

HealthRecon was certified a Great Workplace by Great Place to Work® Sri Lanka for five consecutive years and was adjudged one of the 40 Best Workplaces in Sri Lanka in 2021. HealthRecon is also a Signatory Participant of the United Nations Global Compact.

**Job Vacancy**:
ED Professional Coder

**Work Week**:
Monday to Friday

**Shift Window**:
12:00 PM - 9:00 PM IST (Straddle Shift)

**Other Features**:
Full-time
US calendar applicable

**Key Responsibilities**:

- Review and analyze medical documentation for emergency department (ED) encounters to extract relevant information, such as diagnoses, procedures, and services rendered.
- Assign appropriate ICD-10-CM, CPT, HCPCS, and other applicable codes to represent the services provided accurately.
- Adhere to coding guidelines, including official coding guidelines, local coverage determinations, and other regulatory requirements.
- Ensure compliance with relevant coding and documentation standards, such as the International Classification of Diseases (ICD) coding systems, Current Procedural Terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS), and any other coding guidelines specific to the facility or payer.
- Collaborate with healthcare providers, physicians, and other relevant staff to clarify documentation and obtain additional information when necessary to support accurate coding.
- Review medical records for completeness, accuracy, and consistency, and work with the clinical team to ensure proper documentation of diagnoses, procedures, and services.
- Stay updated with changes in coding guidelines and regulations, attend relevant training and educational sessions to enhance coding skills and knowledge.
- Participate in internal and external coding audits to assess coding accuracy, identify areas for improvement, and implement corrective actions as needed.
- Collaborate with compliance and audit teams to address any coding-related issues or discrepancies.
- Perform quality checks on coded data and claims to ensure compliance with coding standards and regulatory requirements.
- Translating patient information into alpha-numeric medical codes using patient treatment, health history, diagnosis, and related information.
- Assigns codes for diagnoses, treatments, and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
- Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.
- Able to accurately abstract information from the medial records into the abstract system, according to established guidelines.
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines.
- Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (i.e.: NDC #, or number of units).
- Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity.
- Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns.
- Meet and/or exceed the established coding productivity standards.
- Effectively communicates with clinicians and billing/coding teams regarding code changes and denials.
- Complete accountable work related to daily unbilled charges to ensure timely billing in conjunction with billing and compliance guidelines.
- Address appeals and review documentation needed for insurance denials to facilitate expedient resolution and reimbursement.

**Qualifications/Criteria**:

- Certified Professional Coder (CPC) or equivalent medical coding certification (e.g., CCS-P).
- At least 2 years of coding experience.
- Strong knowledge of ICD-10-CM, CPT, HCPCS, and other relevant coding systems and guidelines.
- Familiarity with emergency department procedures, terminology, and common diagnoses.
- Proficient in using coding software and Electronic Health Record (EHR) systems.
- Excellent attention to detail and analyt