About this role
Responsibilities
- Review and analyze ED medical records to assign accurate ICD-10-CM, CPT, and HCPCS codes for E/M services, procedures, and diagnoses.
- Apply Medical Decision Making (MDM) table guidelines to determine the correct E/M level for ED visits.
- Ensure coding compliance with federal, state, and payer-specific regulations.
- Collaborate with ED physicians / clinical staff / internal team to resolve coding discrepancies and documentation gaps.
- Appropriate modifiers in accordance with coding guidelines and payer requirements.
- undefined Educate providers on documentation requirements for MDM components (number of diagnoses, data review, risk assessment).
- Conduct ED-specific coding audits and provide actionable feedback to improve accuracy and compliance.
- Stay updated on CMS guidelines, AMA CPT updates, and payer-specific ED coding policies.
- Good understanding of Emergency Department (ED) workflows, patient encounters, and documentation requirements.
- Qualifications: Certification in medical coding (CPC, COC, CCS, or equivalent).
- Minimum 3 years of experience in Emergency Department coding.
- Strong understanding of MDM table application for E/M coding.
- Thorough knowledge of ICD-10, CPT, and HCPCS coding systems.
- Strong knowledge of medical terminology, anatomy, and ED workflows.
- Exceptional attention to detail and accuracy.
- Excellent communication and interpersonal skills.
- Preferred Skills: Ability to work independently and collaboratively within a team.
- Proficiency in coding software and EHR systems.
- Strong analytical and problem-solving skills.
- Ability to interpret payer guidelines and NCCI edits.
- Commitment to continuous learning and professional development.