Position Summary:

Performs coding in accordance with Adirondack Health (AH) approved, CMS, and AMA coding guidelines which includes inpatient, ambulatory surgery, referred outpatient services, professional services for employed or contracted providers at any of the AH campus locations.

Medical records are reviewed and accurately coded with the appropriate ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS, Evaluation and Management codes.  All inpatient medical records are classified to the correct MDC/DRG based on the payment methodology for that specific financial class (MS, AP, APR DRGs).  Ambulatory Surgery patient records are run through the APC finder for edits and grouped into either the APC or APG.

Correct Coding Initiative (CCI) edits and Medical Necessity edits are generated on all coded cases and the coders “work” these edits to help with clean claims submission.

Educational Requirements/ Qualifications:

1. High School diploma or equivalent. 

2.   At least one professional coding certification (through AAPC or AHIMA) required.  A thorough understanding of anatomy and physiology and medical terminology is required. 

1. At least seven years of demonstrated certified medical coding experience is required.