Medical Coder Resume Examples and Templates

Senior Medical Coder

• Evaluate medical bills, ensuring consistency and accuracy of claims.
• Analyze coding for errors and deny incorrect claims.
• Conduct random or focused reviews of medical records.
• Make referrals and collaborate with Medical Directors.
• Assess medical records against clinical and reimbursement policies.
• Maintain adherence to quality assurance standards.
• Serve as a resource to facilitate understanding of Clinical Editing Team and Complex Claim Unit Programs.
• Handle escalated cases promptly.
• Seek supervisory assistance for problem-solving and decision-making when necessary.
• Report any concerns or complaints expressed by healthcare professionals to supervisory staff.
• Maintain effective communication, courtesy, and professionalism in all interactions.
• Collaborate with contracting and provider relations as needed to meet customer needs.
• Analyze clinical information and make appropriate recommendations.
• Identify and refer cases for possible fraud to the appropriate departments.
• Participate in special projects as required.
• Handle multiple products and benefit plans.
• Perform additional duties as assigned.

Ambulance Medical Coder

• Verified signatures and ensured medical charts were complete and accurate.
• Reviewed patient charts to gain a comprehensive understanding of health histories, diagnoses, and treatments.
• Entered patient information into an EMR system (TraumaSoft) and assigned procedure and diagnostic codes for billing purposes.
• Selected appropriate descriptive codes when multiple anatomical locations were indicated.
• Coded emergent and non-emergent ambulance trips at a rate of 80 charts per day.
• Utilized various coding books, procedure manuals, and online encoders effectively.
• Demonstrated active listening, interpersonal skills, and telephone etiquette when communicating with others.

Ambulance Medical Coder

• Conducted billing and coding procedures for ambulance trips.
• Applied official coding conventions and rules from the American Medical Association and Centers for Medicare and Medicaid Services to input diagnostic codes.
• Ensured accuracy of coded data to prevent fraud and abuse and to reflect services provided.
• Identified diagnoses and procedures and selected accurate coding sequences, including ICD-10, HCPCS, and CPT codes, while meeting the required quota of 281 records.
• Reviewed and interpreted documentation from 281 medical records.

Certified Medical Coder II

• Accurately assign ICD and CPT codes to patient records based on the provided documentation.
• Review patient charts and identify any discrepancies or missing information in the documentation that may affect coding accuracy.
• Interpret medical terminology and diagnoses to translate them into coding software.
• Provide guidance and training to physicians and staff on medical coding practices and documentation requirements.
• Ensure compliance with medical coding policies, guidelines, and regulations.

Medical Coder

• Process insurance pre-authorization requests and communicate with insurance companies to obtain necessary approvals.
• Handle claims submission and resubmission, addressing any rejections or denials.
• Proficient in using insurance portals for efficient claims management.
• Accurately assign diagnosis and procedure codes to ensure proper billing and reimbursement.
• Familiar with DHA portals and proficient in navigating them for insurance-related tasks.
• Well-versed in dealing with various insurance Third Party Administrators (TPA) and payers.

Medical Coder

• Follow up with insurance companies to ensure timely payment processing.
• Conduct internal audits and reconciliation to maintain accurate financial records.
• Handle day-to-day activities, including email management and general office duties.
• Maintain high standards of quality assurance, including addressing telephonic queries.
• Utilize effective people management and organizational skills to plan and provide training to staff.
• Possess knowledge about pharmacy insurance-related queries, dealing with insurance companies, checking remittance, and preparing reports.
• Conduct performance reviews and internal audits to encourage professional development and identify areas for improvement.

Medical Coder

• Generate coded information by reviewing clinical information and translating it into appropriate codes using ICD-10-AM code set and ACHI code set.
• Provide classified data for patient population health, health information exchange, physician performance and utilization review, insurance, planning, and forecasting for healthcare services.
• Contribute to writing medical coding policies and procedures within the organization.

Sr. Medical Coder / Physician Documentation Trainer

• Schedule and conduct new provider training, perform follow-up audits with training, bi-annual audits, and annual audits, and ensure timely submission of new, revised, and deleted CPT, HCPCS, and ICD-10 codes.
• Provide assistance with coding inquiries, super bills, E/M services, procedural documentation, and PATH attestation(s) in compliance with Federal regulations and guidelines.
• Code multi-specialty E/M services, work with high volume claim files, handle invoice corrections, and perform various other tasks typical to medical coding practices as a member of the coding unit.
• Proficient in systems such as Centricity, SCM, IDX, Patient Keeper, E-Bridge, Microsoft Word, and Excel.

Medical Coder / Biller

• Proficient in surgical coding, E/M coding, relevant pathology coding, and radiation IMRT coding.
• Responsible for handling all coding and billing tasks for a team of four surgeons and one radiation oncologist.
• Ensure accurate and timely coding of surgical procedures, evaluation and management services, pathology procedures, and radiation therapy treatments.
• Review medical documentation and apply appropriate codes based on the procedures performed and the guidelines set forth by coding and billing regulations.
• Collaborate with physicians and other healthcare professionals to clarify documentation and obtain necessary information for coding accuracy.

Medical Coder

• Assigning accurate diagnoses and procedures codes for outpatient and inpatient encounters in clinics, hospitals, and out-of-office procedures.
• Ensuring proper coding of ICD-10, CPT, and HCPCS charges for entry into relevant systems.
• Collaborating with healthcare providers to obtain necessary documentation and clarification to ensure accurate coding.
• Reviewing denial trends and implementing measures to resolve and prevent future denials.
• Keeping updated with coding guidelines and regulations to ensure compliance and optimize reimbursement.
• Working closely with billing and reimbursement teams to address coding-related issues and facilitate claims processing.

Medical Coder

• Accurately code and analyze emergency room charts to reflect the documented diagnoses and procedures performed.
• Review laboratory, radiology, pathology reports, and clinical studies to determine the appropriate diagnosis codes based on the findings.
• Ensure coding is aligned with existing diagnoses and medical records to support accurate billing and reimbursement.
• Apply knowledge of coding guidelines and regulations to assign the most appropriate diagnosis codes.
• Collaborate with healthcare providers to clarify documentation and ensure accurate coding.

Medical coder and Biller

• Provided medical billing and coding services for a team of 12 cardiologists.
• Utilized next-gen and epic billing software to electronically bill claims.
• Demonstrated extensive knowledge of Medicare and Medicaid guidelines and procedures.
• Applied in-depth understanding of medical terminology, ICD-9, CPT coding, and HCPCS.
• Accurately coded procedures using CPT coding guidelines.
• Ensured compliance with coding regulations and guidelines for accurate and timely reimbursement.
• Collaborated with healthcare providers to clarify documentation and ensure accurate coding.
• Stayed updated on industry changes and coding updates to maintain compliance and accuracy in coding practices.

Junior Medical Coder

• Receive and thoroughly review patient charts and documents to ensure accuracy and completeness.
• Verify the currency and validity of all codes used in coding processes.
• Identify and report any missing or incomplete documentation to the appropriate healthcare providers.
• Meet daily coding production targets while maintaining a high level of accuracy and quality.
• Ensure proper coding on provider documentation to accurately reflect the services provided.
• Adhere to coding guidelines, including ICD-10 and HCPCS, and comply with legal requirements such as HIPAA regulations to ensure data privacy and security.

Medical Coder

• Conducted thorough patient interviews to gather comprehensive case histories and relevant medical information.
• Scheduled diagnostic, surgery, and medical appointments efficiently to ensure timely and appropriate patient care.
• Electronically supplied accurate ICD-10 and CPT codes on physician orders and referrals for proper billing and coding purposes.
• Performed wound care, blood draws, and EKG testing to support patient care and diagnostic procedures.
• Provided training and guidance to existing and new hire employees to ensure adherence to best practices and quality standards.
• Collaborated closely with physicians and management to implement new policies and procedures, promoting efficient and effective healthcare delivery.

Medical Coder

• Accurately and efficiently assign appropriate ICD-10 and CPT codes to medical charts to ensure proper reimbursement and compliance with coding guidelines.
• Interpret complex medical terminology and documentation to accurately translate it into relevant codes.
• Stay updated on all policies, procedures, and regulations required by government agencies, state authorities, and third-party payors.
• Identify and rectify any discrepancies or inconsistencies in the medical charts to ensure accurate coding and billing.
• Review claim edits and clearing house rejects to resolve any coding-related issues and ensure clean claims submission.
• Maintain open communication with physicians, providing feedback and conducting audits to improve coding accuracy and documentation.
• Assist in providing coding training and support to new physicians, ensuring their understanding of coding guidelines and best practices.

Medical Coder

• Accurately assign appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes to diagnoses and procedures.
• Ensure codes are accurate, complete, and sequenced correctly according to government and insurance regulations.
• Collaborate with clinical staff to clarify and obtain necessary documentation for accurate coding.
• Conduct research and consult references to resolve complex or unusual coding scenarios.

Medical Coder

• Auditing chart for quality check
• Assessing quality drop by analysing reports
• Root cause analysis based on audit Conducting Quality improvement Programs(QIP) based on Error category reports.
• Providing education regarding Current updates and guide

Medical Coder

• Review and analyze patient's diagnosis to accurately assign appropriate codes.
• Evaluate medical necessity of treatments, services, or supplies based on patient's condition and documentation.
• Identify and document all treatments, services, and supplies provided to the patient.
• Take into consideration any unusual circumstances or medical conditions that may have impacted the treatments and services rendered.