Clinical Coder
Clinical coders translate descriptions of medical diagnoses and procedures into codes, which record health care data.
Clinical coders may perform the following tasks:
- read and analyse medical records to help identify all diagnoses, operations and procedures relevant to the current period of patient care
- clarify inconsistent, doubtful or non-specific information in a medical record by consulting with the responsible medical practitioner
- allocate codes to patients' current period of care, using knowledge of the information contained within the International Classification of Diseases, 10th Revision, commonly referred to as ICD-10-AM
- conduct assessment of work to make sure that there is continuous improvement in ICD-10-AM coding and collection of quality health data
- assess the medical record content and highlight shortcomings to management
- maintain ICD-10-AM coding books to make sure they are updated to the current version being used
- assist with the education of clinical staff with regard to ICD-10-AM
- work with computing and finance staff
- assist with medical research and casemix (patient statistics) projects.
Clinical coders work closely with medical staff who are responsible for recording the information required for coding medical data within the patient's medical record.
Personal Requirements:
- able to perform precise and detailed work
- good communication and interpersonal skills
- able to work as part of a team
- interested in health care procedures
- willing to continually update skills and knowledge.
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