Same Day Surgery Medical Coder Job Description Template
The Same Day Surgery Medical Coder plays a critical role in the healthcare system by ensuring accurate coding of outpatient surgical procedures. This position requires detailed knowledge of coding guidelines, medical terminology, and the ability to interpret clinical documentation to support billing and compliance requirements.
Responsibilities
- Review clinical documentation for same-day surgeries to assign accurate CPT, ICD-10, and HCPCS codes.
- Ensure compliance with coding guidelines and regulations to support proper billing.
- Collaborate with healthcare providers to clarify documentation and coding queries.
- Update and maintain patient records with precise coding information.
- Participate in regular coding audits and quality assurance processes.
- Stay updated with changes in coding standards, practices, and regulatory requirements.
- Contribute to team efforts by achieving individual and departmental goals.
Qualifications
- Certified Professional Coder (CPC) or equivalent certification required.
- At least 2 years of experience in medical coding, preferably in a surgical setting.
- In-depth knowledge of CPT, ICD-10, and HCPCS coding systems.
- Strong understanding of medical terminology and surgical procedures.
- Excellent attention to detail and accuracy in coding and documentation.
- Ability to work independently and meet tight deadlines.
- Strong communication and collaboration skills.
Skills
- CPT coding
- ICD-10 coding
- HCPCS coding
- Medical terminology
- Clinical documentation review
- Billing compliance
- Coding software proficiency
- Attention to detail
- Communication
- Time management
Frequently Asked Questions
A Same Day Surgery Medical Coder is responsible for translating healthcare services into standardized codes for documentation and billing purposes. They specialize in surgeries that do not require an overnight hospital stay, ensuring accurate coding for procedures and diagnoses. Coders review patient records, assign codes using classification systems like ICD-10-CM, CPT, and HCPCS, and ensure compliance with regulations.
To become a Same Day Surgery Medical Coder, individuals typically need a high school diploma followed by specialized training in medical coding. Many pursue certifications like the Certified Professional Coder (CPC) or Certified Outpatient Coder (COC). Gaining experience in a healthcare setting, particularly in surgical departments, and familiarity with coding certification exams can enhance prospects.
The average salary for a Same Day Surgery Medical Coder varies based on factors like location, experience, and certifications. Generally, these coders can expect competitive salaries compared to other medical coding roles. Benefits often include healthcare coverage, paid time off, and opportunities for professional development within healthcare institutions.
Key qualifications for a Same Day Surgery Medical Coder include a high school diploma or equivalent, followed by certification from recognized bodies like AAPC or AHIMA. Essential skills include proficiency in medical coding systems such as ICD-10-CM, CPT, and HCPCS, as well as attention to detail, organizational skills, and a deep understanding of medical terminology and surgery procedures.
A Same Day Surgery Medical Coder must possess strong analytical skills, attention to detail, and familiarity with coding systems like ICD-10-CM, CPT, and HCPCS. Responsibilities include reviewing medical records, verifying diagnoses and procedures, ensuring regulatory compliance, and collaborating with healthcare professionals. Coders must also continuously update skills and knowledge of coding regulations and guidelines.