Medical Coder
Job Description
Job Summary
GluCare is a Technology company disguised as a Diabetes Clinic. We use technology enhanced services to provide metabolic health service, primarily for diabetes and other endocrinology services as well as common comorbidities. We are looking for a coder to assist us with our insurance claims.
Duties and Responsibilities:
● Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
● Researches and analyzes data needs for reimbursement.
● Analyzes medical records and identifies documentation deficiencies.
● Serves as resource and subject matter expert to other coding staff.
● Reviews and verifies documentation supports diagnoses, procedures and treatment results.
● Identifies diagnostic and procedural information.
● Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
● Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
● Follows coding conventions. Serves as coding consultant to care providers.
● Identifies discrepancies, potential quality of care, and billing issues.
● Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.
● Identifies reportable elements, complications, and other procedures.
● Serves as resource and subject matter expert to other coding staff.
● Assists lead or supervisor in orienting, training, and mentoring staff.
● Provides ongoing training to staff as needed.
● Handles special projects as requested.
● Work with insurance manager to reduce rejection rates
● Understands insurance companies policies regarding eligibility, approvals, and other requirements to enhance the coding process
● Works with insurance manager to Interact daily with doctors, nurses, and other healthcare professionals to ensure accuracy and completion of coding as necessary.
● Maintains strict confidentiality related to medical records and other data.
