A medical coder, also known as a Certified Professional Coder, is responsible for translating patient medical records into codes that insurers use to process claims. This involves reviewing medical records, transcriptions, test results, and other documentation to identify missing information, confirm treatments, and assign codes to procedures and diagnoses. The medical coder then uses these codes to create claims that insurance carriers can pay.

Responsibilities:

Assign accurate medical codes to diagnoses, procedures, and services using appropriate coding systems, such as ICD-10-CM, CPT, and HCPCS.

Review medical records, operative reports, and other documentation to extract relevant information for coding purposes.

Ensure coding compliance with applicable coding guidelines, regulations, and reimbursement policies, such as Medicare or insurance carrier requirements.

Collaborate with healthcare professionals to clarify documentation or obtain additional information necessary for accurate coding.

Resolve coding discrepancies or issues by conducting research, reviewing coding guidelines, or seeking guidance from supervisors or appropriate resources.

Maintain up-to-date knowledge of coding updates, changes, and industry trends by attending relevant training and continuing education programs.

Participate in coding meetings, discussions, and educational sessions to enhance coding knowledge and skills.