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Medical Records Coder II
Duke Careers. Review complex medical records and accurately code primary and secondary diagnoses and procedures using ICD-10-CM and CPT/CPT-4 conventions .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in ICD-10-CM and CPT coding conventions, with a strong understanding of anatomy, physiology, and medical terminology. Capable of conducting audits, coordinating team efforts, and educating healthcare professionals on coding practices.
Highest-signal resume keywords
ICD-10-CM CodingCPT CodingDRG/APC Reimbursement KnowledgeRHIA/RHIT/CCS/CPC/HCS-D CertificationMedical Record Practices
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
ICD-10-CM CodingCPT CodingData EntryMedical TerminologyAnatomy KnowledgePhysiology KnowledgeDRG/APC AssignmentCoding Software FamiliarityAuditing SkillsCoding Guidelines
Soft Skills
Effective CommunicationTeam CoordinationPresentation Skills
Certifications & Qualifications
RHIARHITCCSCPCHCS-D
Industry Keywords
Medical RecordsJCAHOHCFAMRNCCoding Practices
About the role
Key responsibilities & impact- Review complex medical records and accurately code primary and secondary diagnoses and procedures using ICD-10-CM and CPT/CPT-4 conventions
- Coordinate and review the work of designated or subordinate employees
- Conduct regular audits to ensure work quality and quantity
- Research, develop, and present continuing education programs
- Sequence diagnoses and procedures according to coding guidelines
- Ensure accurate DRG/APC assignment
- Abstract and compile medical-record data for optimal reimbursement of hospital or professional charges
- Consult with and educate physicians on coding practices and conventions
- Communicate with nursing and ancillary services personnel to obtain documentation needed for accurate coding
- Maintain knowledge of anatomy, physiology, medical terminology, disease processes, surgical techniques, and coding guidelines through continuing education
- Assist with special projects and perform related duties
Requirements
What you’ll need- High school diploma required
- Must hold one active/current certification: RHIA, RHIT, CCS, CPC, or HCS-D
- RHIA certification: no experience required
- RHIT certification: no experience required
- CCS certification: one year of coding experience required
- CPC or HCS-D certification: two years of coding experience required
- Advanced ICD-10-CM and CPT-4 coding conventions
- Anatomy and physiology knowledge
- Medical terminology knowledge
- Extensive DRG/APC reimbursement knowledge
- Familiarity with coding software
- Data entry/CRT skills
- Effective written and verbal communication skills
- Thorough understanding of medical record practices, standards, regulations, JCAHO, HCFA, and MRNC requirements
- Remote workers must reside in one of the listed eligible states
Benefits
Comp & perks- $10,000 sign-on bonus paid in 4 equal installments over 24 months at 6-month increments
- 100% remote work arrangement
- Continuing education programs
- Equal employment opportunity and inclusive workplace commitment
- Reasonable accommodation support