Medical Coder job description

What is a Medical Coder?

A Medical Coder is a specialized administrative professional in the healthcare industry who analyzes clinical statements and assigns standardized codes using classification systems like ICD-10, CPT, and HCPCS. They serve as critical liaisons between healthcare providers, insurance companies, and regulatory bodies, transforming complex medical documentation into universally recognized codes that drive reimbursement, data tracking, and compliance. Their work requires meticulous attention to detail, a strong understanding of medical terminology, anatomy, and pathophysiology, as well as knowledge of insurance guidelines and federal regulations like HIPAA.

What does a Medical Coder do?

Medical Coders review patient medical records, including physician notes, lab results, and procedure reports, to identify diagnoses and services provided. They assign appropriate codes using standardized classification systems to ensure accurate insurance billing and reimbursement. They verify documentation completeness and clarify inconsistencies with healthcare providers when necessary. Additionally, Medical Coders maintain patient confidentiality, adhere to coding guidelines and compliance regulations, and may assist with denied claims by providing coding-related appeals support. Their work directly impacts revenue cycle management and healthcare data integrity.

Job Overview

A Medical Coder is responsible for reviewing and translating healthcare services, procedures, diagnoses, and equipment into universal medical codes. This role ensures accurate billing and compliance with federal regulations and insurance requirements. The ideal candidate will possess strong attention to detail, extensive knowledge of medical terminology, and proficiency with coding systems such as ICD-10, CPT, and HCPCS.

Medical Coder responsibilities include:

Must-Have Requirements

Preferred Qualifications

Bonus Skills