Medical Coder
Madera, CA jobs
This position is responsible for accurately assigning ICD-9-CM/ICD-10-CM diagnosis and procedure codes and CPT-4 procedure codes to inpatient and outpatient medical records using the 3M encoding software. The role includes assigning HCFA-DRG and APR-DRG groupers for inpatient records and abstracting clinical, financial, trauma, and quality management data into the organization's health information system. Additionally, this position monitors accounts receivable, abstract and claims rejections, and other related billing reports. Inpatient hospital coding constitutes 70% or more of the total coding workload.
Experience Requirements
Minimum of one (1) year of experience using ICD-10-CM/PCS and CPT-4 coding classification systems
Working knowledge of encoder software, MS-DRG and APR-DRG groupers, and AHA Coding Guidelines
Demonstrated proficiency in data entry and the ability to perform mathematical calculations accurately
Education, Licensure, and Certification
High school diploma or GED accredited by the U.S. Department of Education required
Successful completion of a formal training program in ICD-10-CM/PCS and CPT coding, anatomy and physiology, and medical terminology required
Certified Coding Specialist (CCS) credential required
Position Details
This is a part time (20 hours per week) hybrid position, combining remote work with regular on-site responsibilities and presence required based on departmental needs and organizational priorities.
About Valley Children's Healthcare
Valley Children's Healthcare is an award-winning pediatric healthcare system located in Madera, California, in the heart of the affordable Central Valley. The organization operates one of the nation's largest pediatric healthcare networks, including a 358-bed children's hospital and multiple outpatient clinics. Valley Children's offers access to three national parks and is within driving distance of California's world-renowned coastline, providing an exceptional balance of professional opportunity and quality of life.
Coding Specialist II, Remote
Somerville, MA jobs
Site: Mass General Brigham Incorporated
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
This position will be coding for Pain Management/ Anesthesia.
Job Summary
Summary:
Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations
Does this position require Patient Care? No
Essential Functions
Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information.
-Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies.
-Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes.
-Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials.
-Utilize coding software, encoders, and electronic health record systems to facilitate the coding process.
-Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives.
-Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges.
Qualifications
Education
High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred
Experience
Medical Coding Experience 3-5 years required
Knowledge, Skills and Abilities
- In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing.
- Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations.
- Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes.
- Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding.
- Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff.
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Additional Job Details (if applicable)
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$21.78 - $31.08/Hourly
Grade
4
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
Auto-ApplyRemote - Inpatient Coder II
Remote
Remote - Inpatient Coder II
Inpatient Coding
Full Time Status
Day Shift
Pay: $24.74 - $37.11 / hour
Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.
This position is responsible for assigning ICD-10-CM and ICD-10-PCS codes for inpatient and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic, anatomy and physiology.
This position works under the supervision of the Manager and is employed by Mosaic Health System.
Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines and organizational compliance standards.
Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation.
Completes complex coding assignments for reimbursement, research and compliance with Federal and State regulations. Researches coding guidelines. Reviews and appeals coding denials.
Educates/Communicates with providers, querying providers to ensure that optimal clinical documentation is provided to demonstrate the severity and details of the patient's illness in the medical record.
Coordinates/Communicates with departments including clinical departments, Quality Improvement, Care Management, Patient Financial Services to ensure accuracy and timeliness of coding.
Ensures data accuracy by responding to coding edits received.
Cross-trained and able to complete one type of outpatient facility coding in addition to inpatient coding. Example: Emergency Department, Observation, Referral.
Mentors and assists with training coders.
Completes analysis by utilizing reports, record reviews, etc.
Other duties as assigned.
Must have coding education. Associate's Degree or higher in Health Information Management / Medical Records required.
CCS - Certified Coding Specialist, RHIA - Registered Health Information Administrator, or RHIT - Registered Health Information Technician required.
Three years experience in coding in an acute care setting required.
Remote - Clinic/Outpatient Coder III
Remote
Remote - Clinic/Outpatient Coder III
Outpatient Coding
PRN Status
Variable Shift
Pay: $24.74 - $37.11 / hour
Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.
Expected to be proficient in assigning ICD-10-CM and/or CPT codes for following types of services: Outpatient: Complex Surgeries, Observations (non-obstetric), Interventional radiology, radiation oncology and/or non-complex inpatient coding encounters. Clinic coder: Either proficient in coding for all non-surgery specialty areas, primary care, or complex surgeries.
This position works under the guidance and supervision of the HIM Outpatient APC and Clinic Coding Manager and is employed by Mosaic Health System.
Codes procedures and diagnoses using the ICD-10-CM, CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards.
Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation.
Communicates with providers, querying providers to ensure the highest level of specificity is provided in documentation.
May assist in training of newly hired coders.
Caregiver may work in conjunction with Patient Financial Services to verify and modify charges and coding to ensure accuracy of supporting documentation, payer rules and correct coding.
Working reports for clean-up, auditing services, edits, and denials.
Ensures data accuracy of State HIDI data by responding to edits received.
Performs other duties as assigned.
Must have coding education, HS Diploma and Medical Terminology and Anatomy and Physiology
Required to obtain CCS - Certified Coding Specialist or RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CPC and/or CCSP - Certified Professional Coder within 180 days of employment. Must also obtain COC - Certified Outpatient Coding within 180 days of employment.
Five years experience in a Health Information Services department performing a job that requires detail, and familiarity with patient medical record preferred.
Clinical Coder IV/Acute Care - Medical Records
Charlotte, NC jobs
00153661
Employment Type: Full Time
Shift: Day
Shift Details: Monday-Friday 1st shift
Standard Hours: 40.00
Department Name: Medical Records
Location Details: Onboarding at Arrowpoint, after training able to work remote
Carolinas HealthCare System is Atrium Health. Our mission remains the same: to improve health, elevate hope and advance healing - for all. The name Atrium Health allows us to grow beyond our current walls and geographical borders to impact as many lives as possible and deliver solutions that help communities thrive. For more information, please visit carolinashealthcare.org/AtriumHealth
Job Summary
To support World Class Service Lines, and with Documentation Excellence (DE) as the primary objective, the Clinical Coder IV reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate codes for billing, internal and external reporting, research and regulatory compliance. An option to work as part of the clinical team and perform high level, service line based concurrent coding is also available. This position also enjoys the advantages of free CEUs and one paid professional membership.
Essential Functions
Reviews medical records of high complexity to identify the appropriate principal diagnosis and procedure codes, all other appropriate secondary diagnoses and procedure codes. Assign and present on Admission, Hospital Acquired Condition and Core Measure Indicators for all diagnosis codes.
Facilitates appropriate MS-DRG for inpatient medical records and appropriate APC assignment for outpatient medical records using UHDDS and other facility guidelines.
Demonstrates the technical competence to use the facility encoder as it interfaces with the hospital mainframe and/or EMR in an on-site or remote setting.
Reviews charges and Evaluation and Management levels.
Demonstrates proficiency with Microsoft Office Applications and in using required computer systems with minimal assistance.
Abstracts coded data and other pertinent fields in the hospital electronic health record.
Ensures the accuracy of data input.
Meets established quality and productivity standards.
Facilitates peer review and training for all Acute Clinical Coders in the coding department. Provides support to management.
Stay abreast of coding principles and regulatory guidelines related to inpatient and/or outpatient coding.
Physical Requirements
Must be able to concentrate and sit for long periods of time while reviewing electronic health records. Daily and weekly deadlines must be met in a fast paced office environment and/or at home environment.
Education, Experience and Certifications.
High school diploma or GED required; Bachelors degree preferred. Advanced knowledge in Medical Terminology, Anatomy and Physiology and Pharmacology required. 4 years coding experience in acute care setting required. Current RHIA, RHIT, CCS, CPC-H, CPC or CIC required plus a passing score on the CHS Coding test.
At Atrium Health, formerly Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations.
As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve.
Posting Notes: Not Applicable
Carolinas HealthCare System is an EOE/AA Employer
Risk Adjustment Medical Coder
Boone, NC jobs
Job DescriptionDescription:
Full Time, Remote
Exempt / Salary
Organization
High Country Community Health (HCCH) is a federally funded Community and Migrant Health
Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of
HCCH is to provide comprehensive and culturally sensitive primary health care services that
may include dental, mental and substance abuse services to the medically under-served
population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural
communities.
Supervisory Relationship:
Reports to: Deputy CFO
Job Summary and Responsibilities
Provides thorough concurrent, prospective, and retrospective review of ambulatory medical
record clinical documentation to ensure accurate and complete capture of the clinical picture,
severity of illness, and patient complexity of care. Utilizes knowledge of official coding
guidelines, HCC standards, Risk Adjustment Factor (RAF) scoring, and physician query briefs.
Will participate in Provider education on the importance of diagnosis specificity and
documentation guidelines. The Risk Adjustment Coder works to maintain a thorough knowledge
of our current automated eClinicalsWork (eCW) enterprise billing system, through which the
coding and documentation review are functionalized to provide support to HCCH providers and
staffs as necessary. Provides subject matter expertise to others including staff in the Billing
department as necessary. This position requires professional maturity, responsibility, integrity,
and subject matter expertise to complete the work timely; communicate setbacks to deliverables.
and to collaborate with others to meet production and quality standards.
Responsibilities include:
-Review and accurately code medical records and encounters for diagnoses and
procedures related to Risk Adjustment and HCC coding guidelines
-Validate and ensure the completeness, accuracy, and integrity of coded data.
-Concurrently, prospectively, and retrospectively review medical records to identify
unclear, ambiguous, or inconsistent documentation ensuring full capture of severity,
accuracy, and quality.
-Query providers when documentation in the record is inadequate, ambiguous, or
otherwise unclear for medical coding purposes.
-Utilizes approved resources to determine the appropriate ICD-10-CM, CPT, and/or
HCPCS and ensures documentation in the medical record follows official coding
guidelines, internal guidelines, and AHIMA physician query brief standards.
-Comply with the Standards of Ethical Coding as set forth by the American Health
Information Management Association and adhere to official coding guidelines.
-Comply with HIPAA laws and regulations.
-Maintain coding quality and productivity standards set forth by HCCH.
-Maintain competency in evolving areas of coding, guidelines, and risk adjustment
reimbursement reporting requirements.
-Assist in internal and external coding audits to ensure the quality and compliance of
coding practices.
-Provide ongoing feedback to physicians and other providers regarding coding guidelines
and requirements, including education and support for improvement in HCC coding, and
RAF scoring.
-Assist with educational in-services for physicians, other providers, and clinic staff
relating to coding and documentation compliance as well as new policies and procedures
relating to clinical documentation compliance related to billing.
-Maintains complete confidentiality of patient information.
-Assists with developing, implementing, and reviewing policies, procedures, and forms
related to areas of responsibility.
-Other duties as assigned by your Supervisor.
Requirements:
Requirements/Skills/Experience
-High-speed internet access
-Strong clinical knowledge related to chronic illness diagnosis, treatment, and
management.
-Knowledge and demonstrated understanding of Risk Adjustment coding and data
validation requirements is highly preferred.
-Personal discipline to work remotely without direct supervision
-Dental coding skills a plus
-Knowledge of HIPAA, recognizing a commitment to privacy, security, and
confidentiality of all medical chart documentation.
Qualifications:
-Bachelor's degree in allied health or any related field required.
-Minimum 2 years of progressive Professional Risk Adjustment Coding experience
required.
-Active Certified Risk Adjustment Coder certification (CRC and/or CPC) required
-Candidates hired with active CPC, but without Certified Risk Adjustment Coder
certification (CRC) must obtain CRC certification within 9 months of hire.
Travel Requirements
None.
Salary
Commensurate with experience, education and certifications
Home Health and Hospice Coder
San Diego, CA jobs
Job Details LHSD - SAN DIEGO, CA Fully Remote $27.00 - $31.00 HourlyDescription
Who We Are:
Lorian Health is a home health and hospice agency seeking energetic candidates to join our team of skilled professionals. Come join a home health agency that is thoughtful, generous, and family-oriented, placing focus on taking the best care of our patients and our employees!
Lorian Health sets the highest quality standards for home health services in existence today. Foremost of these, is our belief in equanimity in regard to the treatment of all our patients.
Lorian Health is committed to fostering a socially responsible environment within our organization and community and is determined to provide the highest caliber of health care for our patients and their families.
What We Offer:
We offer a comprehensive employee benefits package that includes, but is not limited to:
Health, Dental, Vision, 401K with company match
Competitive pay
Paid vacation, holidays, and sick leave
Full time includes company paid health insurance, dental insurance, vision insurance, paid life insurance, supplemental insurance and 401(k) plan with 4% match, as well as annual accrual of 10 vacation days,10 sick days, 9 holidays.
Join our innovative team to help patients empower themselves to improve self-care.
Qualifications
Requirements:
Must live in Pacific, Mountain or Central Time Zones
Completion of coding specific coursework
Current ICD-10 Coding Certification (HCS-D, BCHH-C, or HCS-H)
Minimum of 1 year previous experience with Home Health ICD-10 coding with verified employment/experience are required.
Minimum of 1 year previous experience with Hospice ICD-10 coding with verified employment/experience are required.
Knowledge of and ability to follow appropriate skilled documentation under Medicare guidelines and conditions of participation.
Knowledge of Patient Driven Grouping Models (PDGM)
Knowledge of insurance reimbursement procedure.
Ability to maintain confidentiality of records and information.
Ability to be flexible, follow verbal and written instruction while working in a team oriented environment.
Detail oriented with critical thinking and strong clinical judgement and analytical skills.
Ability to demonstrate flexibility in response to unexpected changes in work volume and work schedule.
Excellent interpersonal relation skills including active listening, conflict resolution, and team building.
Communicates effectively with the clinical and office staff involved in any given case in a constructive, goal directed, and professional manner
Excellent computer skills to include Microsoft applications (i.e. Word/Excel) and ability to type at least 40 wpm
Preferred:
OASIS certification (COS-C, HCS-O)
Background on OASIS E
Graduate of Bachelor is Science in health field
Experience with HCHB software
Coder (Local SC Remote)
Greenville, SC jobs
Join OBHG: Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination!
Location: SC Upstate area strongly preferred (Remote). Open to exceptional remote candidates in SC, NC, GA (must be located in these states to be eligible).
The Good Stuff We Offer:
Hourly Compensation Range: $21.00 - $24.00 per hour + eligibily for RCM bonus
A mission based company with an amazing company culture.
Paid time off & holidays so you can spend time with the people you love.
Medical, dental, and vision insurance for you and your loved ones.
Health Savings Account (with employer contribution) or Flexible Spending Account options.
Employer Paid Basic Life and AD&D Insurance.
Employer Paid Short- and Long-Term Disability.
Optional Short Term Disability Buy-up plan.
401(k) Savings Plan, with ROTH option.
Legal Plan.
Identity Theft Services.
Mental health support and resources.
Employee Referral program - join our team, bring your friends, and get paid.
Medical Coder Position Summary: The Certified Coder is responsible for the data abstraction, evaluation and auditing of Provider assigned CPT, HCPC codes, ICD-10 CM for obstetrics.
Essential Medical Coder Responsibilities:
Assigns and sequences diagnoses and procedures in accordance ICD-10 CM Official Coding
Guidelines, CPT Assistant, Physician at Teaching Hospital Rules and Evaluation and Management Documentation Guidelines
Experience with billing, collections from insurance companies and patients, insurance follow up, charge entry
Analyze and resolve charge entry coding errors
Familiar with revenue cycle management processes
Ability to work with eBridge, Putty and Lyra software
Report and analyze errors, trends, and findings
Compose reports using Microsoft Excel and Word
Ability to interpret regulatory and payer rules and directives concerning coding
Ability to function in a high volume environment producing quality work
Solid interpersonal and telephone communication skills
Ability to consistently work independently and problem solve
Must be able to multi-task and prioritize job responsibilities
Must be dependable, responsible and team oriented
Strong attention to detail (such as interpretation of clinical data including medical terminology and disease
processes)
Demonstrate a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
Strong working knowledge of HIPAA as it relates to the entire revenue cycle management cycle process
Perform other duties as assigned.
Essential Skills/Credentials/Experience/Education
Certified AAPC Coder
Associate or Bachelor's Degree, OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE
Skill in operating a personal computer; must be proficient in Word, Excel, Power Point.
Ability to compose letters, memos, and other correspondence.
Effective interpersonal skills required in interactions with Ob Hospitalists and personnel.
Ability to work with highly confidential materials.
Must possess high ethical standards.
Enhances professional growth and development through in-service meetings, education, programs, conferences, etc.
Physical Demands (per ADA guidelines)
Sitting for long periods of time. Occupation requires this activity more than 66% of the time (5.5+ hrs/day)
Senior Hospital Coder - TSH
New Scotland, NY jobs
Department/Unit:
Health Information Services
Work Shift:
Day (United States of America)
Salary Range:
$60,367.47 - $90,551.20The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding.
Essential Duties and Responsibilities
Optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases.
Understands the hospital inpatient/outpatient and CBO billing and registration systems.
Assist with educating providers, clinicians, and others by advocating proper documentation practices and further specificity for both diagnoses and procedures when needed to more precisely reflect the acuity, severity, and the occurrence of events. Bring to the attention of the organization management any identified inappropriate coding practices that do not comply with requirements.
Assist in problem solving processes and workgroups, including participating in the development of query policies that support documentation improvement and meet regulatory, legal, and ethical standards for coding and reporting.
Assist leadership in team collaboration, leading meetings and onboarding new staff.
Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
Responsible for communicating both verbally and written to physicians, clinical departments, medical coders, and management teams.
Query and/or consult as needed with the provider for clarification and additional documentation prior to final code assignment in accordance with acceptable healthcare industry practices.
Provides feedback to coding staff on quality scores.
Communicates with management when trends or concerns arise regarding poor quality.
Schedules calls and is available for coding staff when they have questions related to coding.
Leads a morning huddle one week each quarter in a 12-month calendar year.
Communicates to Coding Support Specialist on topics for monthly meetings.
Research new coding clinics, guidelines, and concepts and provides education to staff.
Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
Research coding forums and coding issues related to registration status.
Works with a multitude of software systems at once, navigating efficiently between them. These systems include Meditech, Soarian Clinicals and Financials, 3M HDM and 360, Outlook, MS Teams, Word, Outlook, Excel, Glens Falls Hospital Citrix, Saratoga Hospital Citrix.
Assists with organizing the shared drive for the medical coding department.
Assist in development and compliance of comprehensive internal coding policies and procedures that are consistent with requirements.
Actively participates in discussions and projects to improve turnaround time for coding.
Participates in daily huddles and LEAN problem-solving activities.
Demonstrates change-leadership skills. Supporting the collaboration of coders to improve inefficiencies and solve problems.
Connect with coders when necessary. Being a mentor and guide to their success.
Qualifications
High School Diploma/G.E.D. - required
Associate's Degree In Health Information Management or related program - preferred
1-3 years Experience in a leadership, supervision, or code auditing position providing quality feedback to staff. - required
2 or more years of experience coding ICD-10-CM/PCS and/or CPT coding. - required
Experience with 3M 360 and EPIC - preferred
Applicants must receive a minimum score of 85% on a coding assessment.
(High proficiency)
Expert level with reading a medical record to assign ICD-10-CM, ICD-10-PCS, and CPT4 codes, abstract data elements for billing and reporting, and assign DRG, APC, and APG as appropriate. (High proficiency)
Highly skilled in team development, critical thinking, organization, verbal, and written communication. Skilled in team-oriented job tasks with providing detail and accuracy, strong customer service skills. (High proficiency)
Ability to work independently and effectively with a team. Knowledge in revenue cycle operations. (High proficiency)
Coding certification / credential through AHIMA or AAPC and be in good standing - required
RHIT / RHIA - preferred
Equivalent combination of relevant education and experience may be substituted as appropriate.
Physical Demands
Standing - Occasionally
Walking - Occasionally
Sitting - Constantly
Lifting - Rarely
Carrying - Rarely
Pushing - Rarely
Pulling - Rarely
Climbing - Rarely
Balancing - Rarely
Stooping - Rarely
Kneeling - Rarely
Crouching - Rarely
Crawling - Rarely
Reaching - Rarely
Handling - Occasionally
Grasping - Occasionally
Feeling - Rarely
Talking - Frequently
Hearing - Frequently
Repetitive Motions - Frequently
Eye/Hand/Foot Coordination - Frequently
Working Conditions
Extreme cold - Rarely
Extreme heat - Rarely
Humidity - Rarely
Wet - Rarely
Noise - Occasionally
Hazards - Rarely
Temperature Change - Rarely
Atmospheric Conditions - Rarely
Vibration - Rarely
Thank you for your interest in Albany Medical Center!
Albany Medical Center is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Thank you for your interest in Albany Medical Center!
Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Auto-ApplyCMS HCC Coder
Orange, CA jobs
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide coding expertise as well as administrative oversight to ensure successful integration of AHC's HCC initiatives.
GENERAL DUTIES/RESPONSIBILITIES
1. Monitors coding & abstracting quality by conducting &/or coordinating ongoing audits to ensure coding quality & performance improvement standards are maintained, achieved & improved.
2. Develops, implements, evaluates & improves IPA's educational tools for their respective providers in order to accurately capture acute and chronic conditions.
3. Tracks & reports progress of the audits performed on the coding vendors in order to assure the coding accuracy and quality of the data submitted to CMS.
4. Works with Risk Adjustment Management on any Data Validation and /or RADV coding audit to ensure completeness and coding accuracy of all submissions to CMS.
5. Maintains a comprehensive tracking and management tool for assigned IPA's within Alignments Healthcare provider network.
6. Tracks all Risk Adjustment activities for assigned medical groups and ensure that all tasks are completed in a timely manner. Correlate activities, processes, and HCC results/ metrics to evaluate outcomes.
7. Ensures compliance with all applicable federal, state &local regulations, as well as with institutional/organizational standards, practices, policies & procedures.
8. Supports the Risk Adjustment Management Team in scheduling/training activities. Maintain records of training.
9. Suggests new Physician Group Risk Adjustment coding initiatives. Participate in SCITs/ Education meetings as needed
10. Coordinates Risk Adjustment audit activities as it relates to the assigned groups. Assist with CMS Data Validation activities, including suggested record selections, tracking and submission, in conjunction with Risk Adjustment Healthcare Management
11. Educates and updates:
a. Regularly updates all Risk Adjustment materials for clinical and official guideline changes.
b. Updates all education materials based on CMS-HCC Model and ICD-9/ ICD-10 annual changes
c. Suggests, updates, and enhances clinical educational materials to assist in training physicians and clinical staff on Risk Adjustment Healthcare Programs including CMS-HCC Models, Clinician Chart Reviews, and Encounter Documentation.
d. Suggests customizations of Risk Adjustment education for various audiences, Support Staff, PCPs, Specialists, Employees vs. contracted and Central Departments
e. Stays current of industry coding, compliance, and HCC issues.
f. Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies.
12. Contributes to team effort by accomplishing related results as needed.
13. Other duties as assigned to meet the organization's needs.
Job Requirements:
Experience:
• Required: Minimum 3+ years of coding in a medical group or health plan setting required; Professional Coding experience required. Minimum 1 year experience with strategic planning in risk mitigation.
•Work Hours: Pacific Standard Time
• Preferred: Previous experience and use of Epic, Allscripts, EZCap a plus
Education:
• Required: High School Diploma or GED.
Training:
• Preferred: Certified Coder training courses
Specialized Skills:
• Required:
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Report Analysis Skills: Comprehend and analyze statistical reports.
• Preferred: Proficient user in MS office suite, MS access a plus
Licensure:
• Required: Certified Coder required, HCC/Risk Adjustment experience, Experience with Athena EHR
• Preferred: CCS, CCS-P, CPC, Certified Auditor a plus.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1 While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $58,531.00 - $87,797.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
Auto-ApplyCertified Medical Coder
Oakland, CA jobs
Temporary Description
The Certified Medical Coder represents Roots Community Health Center, working as part of a team in a highly visible setting. This position provides support to the Director of Billing, Billing and Coding Administrator. This position works in collaboration with the providers, billing specialist and finance team, using efficient medical coding. The Certified Medical Coder provides coding audits of all billing providers within the practice based on documentation guidelines, Medicare Guidelines and coding initiatives. As the coder audits and interprets patient medical records, transcriptions, test results, and other documentation, we'll rely on the coder to ask questions, make coding recommendations, research billable procedures and codes - all to ensure a smooth billing process. This is a 6-month temporary position.
Duties and Responsibilities:
Code office visits and procedures using CPT, ICD-10 codes
Audit and review coding (CPT, ICD-10) physician notes in the EHR
Manage Coder Correct/ Super Coder Codify Platforms (AAPC)
Make coding recommendations; working with providers to ensure accuracy using billing/payer guidelines.
Educate providers on coding policies and guidelines, medical necessity criteria, programs correct billing methods and procedure codes by written and verbal communication
Correspond or meet with providers to resolve billing practices
Audit documentation to ensure it supports complete, accurate and compliant billing with both CMS and payer requirements
Assist practice physicians and managers with all coding errors, denials, or issues encountered in the billing process
Monitor charge review queues to ensure that all accounts flow through to billing appropriately
Submit all charges into billing EHR system AdvancedMD for claims processing
Act as liaison between billing department and clinic management/physicians
Translate written policy interpretation into CPT, HCPC, ICD-10 codes for input into systems
This position is responsible for ensuring compliance with all aspects of applicable regulations, payer billing guidelines.
Identify specific billing and reimbursement projects as they arise
Conduct research coding on denied claims and take steps toward resolution
Correct coding errors in coordination with the billing specialist
Reviews insurance plans and carrier information for appropriate coding regulations per payer contracted services
Verify insurance information/PCP assignment
Ensure/verify the accuracy of patient demographics and insurance information in Electronic Health Record
Report trends and denial patterns to the Director of Billing
Participate in internal chart audits, billing audits, and other compliance programs
Makes recommendations for policies and procedures relating to payer billing guidelines
Attending Billing and Interdepartmental meetings.
Requirements
Competencies:
High School Diploma or GED, Billing/Coding Certification
Must have experience working in non-profit organization or a community clinic preferred, but not required.
Certification in medical billing/coding
Minimum 1 years' experience performing medical billing, claims review
Minimum 1 years' experience with claims follow-up from physician office, third-party setting
Familiarity with medical terminology and the medical record coding process
In-depth knowledge/ awareness of all areas related to Payer-specific (Medicare Medi-Cal Medicaid and/or Private) Claims and how they interrelate
Knowledge of principles methods and techniques related to compliant healthcare billing/collections - Familiarity with Payer-specific (Medicare Medi-Cal Medicaid -CalAim, Private) Claims management
Previous experience with either Electronic Health Record and Practice Management Systems
Full understanding of insurance denials, EDI coding rejections and exclusions
Previous experience with HCFA 1500 claim forms and electronic billing.
Interest/experience working with low-income communities of color
Excellent written and verbal communication skills
Solid organizational skills including attention to detail and multi-tasking skills.
Demonstrates ability to manage time efficiently and multi-task effectively.
Clear and effective external and internal, verbal and written, communication skills.
Strong critical thinker and problem solver
Excellent team-player
Ability to work with patients from different backgrounds (culture competency)
Ability to communicate clearly and respectfully with co-workers and clients
Strong working knowledge of Microsoft Office (Word, Excel, PowerPoint)
Ability/willingness to learn Electronic Health Records Insight reporting
Roots Community Health Center is proud to be an Equal Employment Opportunity/Affirmative Action Employer and values diversity of culture, thought and lived experiences. We seek talented, qualified individuals regardless of race, color, religion, sex, pregnancy, marital status, age, national origin or ancestry, citizenship, conviction history, uniform service membership/veteran status, physical or mental disability, protected medical conditions, genetic characteristics, sexual orientation, gender identity, gender expression regardless of physical gender, or any other consideration made unlawful by federal, state, or local laws. Roots uses E Verify to validate the eligibility of our new employees to work legally in the United States.
Salary Description $31.00-$36.00
HIM Coder II
Goleta, CA jobs
Santa Barbara Cottage Health seeks a HIM Coder II for their Health Information Management department responsible for coding and abstracting diseases and procedures for accurate administrative and clinic data and optimal hospital reimbursement, utilizing coding guidelines as set forth in Coding Clinic for ICD-9-CM and CPT Assistant for CPT/HCPCS. Major accountabilities include:
Codes diseases and procedures abstracted from the medical record according to ICD-9-CM and CPT classification systems, utilizing only recognized coding guidelines.
Abstracts data for coding utilizing the entire medical record in accordance with approved coding guidelines.
QUALIFICATIONS:
All job qualifications listed indicate the minimum level necessary to perform this job proficiently.
Education:
Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-9-CM and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process.
Preferred: Associates Degree Health Information Management.
Certifications, Licenses, Registrations:
Minimum: CSS.
Preferred: CCS and RHIT or RHIA.
Years of Related Work Experience:
Minimum: 1 year.
Preferred: 3 years.
Auto-ApplyHIM Coder II
Goleta, CA jobs
Santa Barbara Cottage Health seeks a HIM Coder II for their Health Information Management department responsible for coding and abstracting diseases and procedures for accurate administrative and clinic data and optimal hospital reimbursement, utilizing coding guidelines as set forth in Coding Clinic for ICD-9-CM and CPT Assistant for CPT/HCPCS. Major accountabilities include:
* Codes diseases and procedures abstracted from the medical record according to ICD-9-CM and CPT classification systems, utilizing only recognized coding guidelines.
* Abstracts data for coding utilizing the entire medical record in accordance with approved coding guidelines.
QUALIFICATIONS:
All job qualifications listed indicate the minimum level necessary to perform this job proficiently.
Education:
* Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-9-CM and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process.
* Preferred: Associates Degree Health Information Management.
Certifications, Licenses, Registrations:
* Minimum: CSS.
* Preferred: CCS and RHIT or RHIA.
Years of Related Work Experience:
* Minimum: 1 year.
* Preferred: 3 years.
Auto-ApplyHIM Coder II
Goleta, CA jobs
Santa Barbara Cottage Health seeks a HIM Coder II for their Health Information Management department responsible for coding and abstracting diseases and procedures for accurate administrative and clinic data and optimal hospital reimbursement, utilizing coding guidelines as set forth in Coding Clinic for ICD-9-CM and CPT Assistant for CPT/HCPCS. Major accountabilities include:
Codes diseases and procedures abstracted from the medical record according to ICD-9-CM and CPT classification systems, utilizing only recognized coding guidelines.
Abstracts data for coding utilizing the entire medical record in accordance with approved coding guidelines.
QUALIFICATIONS:
All job qualifications listed indicate the minimum level necessary to perform this job proficiently.
Education:
Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-9-CM and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process.
Preferred: Associates Degree Health Information Management.
Certifications, Licenses, Registrations:
Minimum: CSS.
Preferred: CCS and RHIT or RHIA.
Years of Related Work Experience:
Minimum: 1 year.
Preferred: 3 years.
Cottage Health is a leading acute care hospital system, located on the central coast of California, widely known for our superior patient care, innovation, medical research and education. Our health system operates primarily in Santa Barbara, Ca, since 1888, and consists of three acute care hospitals, a Rehabilitation Hospital, multiple clinics and a multi-site Urgent Care system. Our mission is to serve the central coast communities with excellence, integrity, and compassion. Every day we touch thousands of lives in many different ways, resolute in our mission to put patients first. We take pride in helping our patients get back to living their lives - in the places they love.
Cottage Health is an Equal Opportunity Employer. Cottage Health applicants are considered solely based on their qualifications, without regard to race, color, ethnicity, religion, age, gender, transgender, gender expression and identity, national origin, ancestry, disability, sexual orientation, marital status, military status or any other classification protected by law. This policy applies to all aspects of the relationship between Cottage Health and an applicant or employee. Cottage Health is committed to upholding discrimination-free hiring practices. We strive to cultivate an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work.
Any Cottage Health applicants who require assistance or reasonable accommodations during the application process may request the need for accommodation with the Recruiter.
If you're already a Cottage Health employee, please apply on this link only.
CH Health Information Management, Part Time Regular , 8 hour, Days, Santa Barbara Cottage Health
Health Information Management -HIM - Coder - Inpatient -REMOTE
Rome, NY jobs
Health Information Management - HIM - Coder - Inpatient
The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations.
Understands importance coding plays in the revenue cycle process
Meets or exceeds coding productivity and quality standards
Assists with DRG appeals as necessary
Assists Coding Manager with identifying problems or trends that need immediate attention
Adheres to all department and hospital policies and procedures
High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required.
KNOWLEDGE AND SKILLS REQUIRED:
Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College.
The best care out there. Here.
Health Information Management (HIM) Coder - Outpatient - PER DIEM
Rome, NY jobs
Rome Health is looking for a per diem OP coder to join the Health Information Management team. This team member will assist with backlogs and coverage during staff PTO.
•Current coding certification required •Three years of experience coding Observation and/or Ambulatory Surgery preferred
•Experience with Clintegrity, Paragon, One Content helpful
•Fully remote after training
Extensive knowledge of medical terminology. Experience in researching and applying coding rules and guidelines required.
Must have experience with data entry of codes into a database. Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
Excellent oral and written communication skills. Must have a positive, respectful attitude.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
Health Information Management - HIM - Coder - Inpatient - REMOTE
Rome, NY jobs
Job Description
Health Information Management - HIM - Coder - Inpatient
The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations.
•Understands importance coding plays in the revenue cycle process
•Meets or exceeds coding productivity and quality standards
•Assists with DRG appeals as necessary
•Assists Coding Manager with identifying problems or trends that need immediate attention
•Adheres to all department and hospital policies and procedures
High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required.
KNOWLEDGE AND SKILLS REQUIRED:
Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College.
The best care out there. Here.
Health Information Management (HIM) Coder - Outpatient - PER DIEM
Rome, NY jobs
Job Description
Rome Health is looking for a per diem OP coder to join the Health Information Management team. This team member will assist with backlogs and coverage during staff PTO.
•Current coding certification required •Three years of experience coding Observation and/or Ambulatory Surgery preferred
•Experience with Clintegrity, Paragon, One Content helpful
•Fully remote after training
Extensive knowledge of medical terminology. Experience in researching and applying coding rules and guidelines required.
Must have experience with data entry of codes into a database. Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
Excellent oral and written communication skills. Must have a positive, respectful attitude.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
Health Information Coder (ICD-10CM)
Fitchburg, WI jobs
Illuminus is seeking a full-time Health Information Coder to join our team. The Coder is responsible for extracting relevant clinical details from patient records to assign accurate diagnostic codes (ICD-10CM) while ensuring compliance with all state and federal regulations and coding guidelines.
This position will work onsite generally Monday - Friday from 8:00am - 4:30pm onsite at our office located at 2970 Chapel Valley Road in Fitchburg, Wisconsin.
Responsibilities
* Maintains and actively promotes effective communication with all individuals.
* Maintains a positive image of the entity in the community keeping in alignment with our mission, vision, and values.
* Maintains working knowledge of laws, regulations, and industry guidelines that impact compliant coding while practicing ethical judgment in assigning and sequencing codes for proper reimbursement.
* Researches and analyzes health records to verify clinical documentation supports diagnosis procedure, and treatment codes.
* Assigns accurate codes for diagnoses and services in accordance with ICD-10-CM, CPT, and HCPCS coding rules and guidelines. Maintain 95% accuracy rate.
* Ensures coding practices comply with federal and state regulations, including HIPAA and CMS guidelines.
* Analyzes health record to ensure accuracy and identifies missing information or documentation deficiencies.
* Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
* Serves as a resource and subject matter expert providing coding education to support providers and other internal departments as necessary.
* Participates in quality assurance and improvement efforts. Researches, analyzes and recommends actions to correct discrepancies and improve coding accuracy and efficiency.
* Maintains confidentiality, privacy and security in all matters pertaining to this position.
* Performs other duties, as assigned.
Requirements
* High School education or equivalent.
* Certification through AAPC or AHIMA (CPC, CCA, CCS, RHIT, or RHIA) or ability to obtain within three months of start date.
* One (1) year of coding experience preferred.
* Strong understanding of medical terminology, anatomy and physiology, pathophysiology, and pharmacology.
* Knowledge and understanding of regulatory and coding guidelines (CMS, HIPAA).
* Knowledge of Patient Driven Payment Model (PDPM) reimbursement system, medical necessity, and denials preferred.
* Proficiency in Electronic Health Record (EHR) systems, and Microsoft Office applications.
* Strong organizational, analytical, and problem-solving skills, and attention to detail.
* Strong Keyboarding and filing abilities.
* Ability to exhibit professionalism, flexibility, dependability, and a desire to learn.
* Ability to effectively communicate with internal and external stakeholders at various levels in a tactful and courteous manner in verbal, nonverbal, and written forms.
* Commitment to quality outcomes and services for all individuals.
* Ability to relate well to all individuals.
* Ability to maintain and protect the confidentiality of information.
* Ability to exercise independent judgment and make sound decisions.
* Ability to adapt to change.
Benefits
* Employee Referral Bonus Program.
* Educational Advancement/Training Opportunities (Wound care, IV administration etc., provided by our Illuminus Institute or Other External Qualifying Educational institution)
* Paid Time Off and Holidays acquired from day one of hire.
* Health (low to no cost), Dental, & Vision Insurance
* Flexible Spending Account (Medical and Dependent Care)
* 401(k) with Company Match
* Financial and Retirement Planning at No Charge
* Basic Life Insurance & AD&D - Company Paid
* Short Term Disability - Company Paid
* Voluntary Ancillary Coverage
* Employee Assistance Program
* Benefits vary by full-time, part-time, and PRN status.
If you are an individual with great attention to detail and accuracy, a passion for people and a desire to make a difference, we encourage you to apply for this exciting opportunity. We offer competitive compensation, benefits, and professional development opportunities. We invite you to apply today or visit our website for more information. We'd look forward to meeting you!
Illuminus is a faith-based, not-for-profit senior living management company dedicated to serving older adults and families throughout the Midwest with skill and compassion. We own or manage over a dozen communities in Wisconsin and beyond, offering independent senior housing, assisted living and memory care, skilled nursing and rehabilitation, low-income senior housing, home health and hospice services via Commonheart management support and consulting.
The people of Illuminus are not just our colleagues, our employees, our residents-they are our parents, our grandparents, our partners, ourselves. We serve others with gratitude, dignity, hope and purpose. We believe that the right care can and will transform us all.
#IlluminusHQ
Salary Description
$22 - $25 per hour depending on experience
Job Description
Rome Health is seeking an experienced HIM Coder. The HIM Coder is responsible for coding discharged patient encounters which may include inpatient, observation, skilled nursing, behavioral health, emergency room, surgical, ancillary, or clinics. Duties may include abstracting and charge verification.
EDUCATION, TRAINING, EXPERIENCE, CERTIFICATION, AND LICENSURE:
High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College.
The best care out there. Here.