Responsibilities
The Coder Specialty Office assures the integrity of the Norton Medical Group billing, insurance, coding, and accounting and referral functions. The incumbent serves as a liaison between the practice and the billing office as well as the accounting department of Norton Healthcare. In performing job functions, utilizes age appropriate principles of growth and development for patients of all ages according to the practice specialty.
**This position offers a fully remote work opportunity. Employees in this role must reside in one of the following states to be considered for fully remote positions: Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina**
Qualifications
Required:
One year medical coding in a specialty office
One of: CCA or CCS or CIC-ICD or COC or CPC or RHIA or RHIT
Desired:
Diploma
Certified Coding Associate OR Certified Coding Specialist OR Certified Inpatient Coder ICD-10 OR Certified Outpatient Coding OR Certified Professional Coder OR Registered Health Information Administrator OR Registered Health Information Technician
$39k-48k yearly est. 2d ago
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Remote Senior Inpatient Coding Specialist
Adventhealth 4.7
Orlando, FL jobs
**Our promise to you:**
Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better.
**All the benefits and perks you need for you and your family:**
+ Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
+ Paid Time Off from Day One
+ 403-B Retirement Plan
+ 4 Weeks 100% Paid Parental Leave
+ Career Development
+ Whole Person Well-being Resources
+ Mental Health Resources and Support
+ Pet Benefits
**Schedule:**
Full time
**Shift:**
Day (United States of America)
**Address:**
601 E ROLLINS ST
**City:**
ORLANDO
**State:**
Florida
**Postal Code:**
32803
**Job Description:**
**Schedule:** Full Time
Reviews, analyzes, and interprets clinical documentation applying applicable codes in accordance with prescribed rules, coding policy, payer specifications, and official guidelines.
Evaluates and optimizes various diagnostic options in accordance with standard rules, official coding guidelines, regulatory agencies, and approved policies.
Verifies assigned codes and ensures diagnostic and procedure codes are supported by the physician's clinical documentation.
Communicates effectively with physicians and allied health personnel to ensure comprehensive, accurate, and timely clinical documentation.
Discusses optimization and documentation issues with physicians and clinical personnel, querying for clarification of discrepancies, additional diagnoses, complications, or co-morbid conditions.
**The expertise and experiences you'll need to succeed:**
**QUALIFICATION REQUIREMENTS:**
Bachelor's, High School Grad or Equiv (Required) Certified Coding Specialist (CCS) - EV Accredited Issuing Body, Certified Radiologic Technologist (R.T.-CERT) - EV Accredited Issuing Body, Infection Control Certification (CIC) - EV Accredited Issuing Body, Registered Health Information Administrator (RHIA) - EV Accredited Issuing Body, Registered Health Information Technician (RHIT) - EV Accredited Issuing Body, Registered Nurse (RN) - EV Accredited Issuing Body
**Pay Range:**
$23.91 - $44.46
_This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances._
**Category:** Health Information Management
**Organization:** AdventHealth Orlando Support
**Schedule:** Full time
**Shift:** Day
**Req ID:** 150659276
$23.9-44.5 hourly 2d ago
Remote Inpatient Coding Specialist
Adventhealth 4.7
Orlando, FL jobs
Our promise to you:
Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
All the benefits and perks you need for you and your family:
* Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
* Paid Time Off from Day One
* 403-B Retirement Plan
* 4 Weeks 100% Paid Parental Leave
* Career Development
* Whole Person Well-being Resources
* Mental Health Resources and Support
* Pet Benefits
Schedule:
Full time
Shift:
Day (United States of America)
Address:
601 E ROLLINS ST
City:
ORLANDO
State:
Florida
Postal Code:
32803
Job Description:
Schedule: Full Time
Shift: Days
Queries physicians for clarification of discrepancies, additional diagnoses, complications, or co-morbid conditions as needed.
Applies ICD-10-CM/PCS codes, MS-DRG codes, Present on Admission codes, and patient status codes, understanding their impact on mortality rates, clinical quality, reimbursement, internal scorecards, and key performance indicators.
Utilizes a thorough understanding of the Official Coding Guidelines, Coding Clinic guidance, medical necessity, and coverage determinations.
Uses critical thinking and sound judgment in decision-making, balancing reimbursement considerations with regulatory compliance.
Reviews encounters for proper admission source, discharge disposition, and assigns the operative physician and date of procedure to the chart coding screen.
The expertise and experiences you'll need to succeed:
QUALIFICATION REQUIREMENTS:
High School Grad or Equiv (Required) Certified Coding Specialist (CCS) - EV Accredited Issuing Body, Certified Professional Coder (CPC) - EV Accredited Issuing Body, Registered Health Information Administrator (RHIA) - EV Accredited Issuing Body, Registered Health Information Technician (RHIT) - EV Accredited Issuing Body
Pay Range:
$21.73 - $40.42
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
$21.7-40.4 hourly 2d ago
EMR Informatics Specialist, Health Information Management, Days Hybrid
Norton Healthcare 4.7
Louisville, KY jobs
Responsibilities
Design and develop electronic medical record keeping and documentation systems. Implement structures and algorithms to optimize the use, storage, and retrieval of medical information.
Key Responsibilities:
Assists with evaluation, design, testing, implementation, upgrades, support, and maintenance of the HIM system(s).
Trains, supports and provides assistance to users; and, provides ongoing education and training when needed.
Provides technical consultation to health information management, other departments, vendors, and information technology on HIM system(s) and processes.
Manages tools such as procedure and information flowcharts, policies and procedures, instructional manuals, and forms in order to promote effective use of applications. Provides documentation and training for users when there is a system change or update.
Special projects as directed.
**This position has the opportunity to work from home. You may be asked to complete training at a Norton Healthcare facility or be able to come to a Norton Healthcare facility for business purposes. Employees in this role must reside in Kentucky or Indiana**
Qualifications
Required:
With an Associates Degree: Three years in Health Information Management or Health Information Technology
With a Bachelor's Degree: One year Health Information Management or Health Information Technology
One of: RHIA or RHIT
Desired:
Bachelor Degree
Registered Health Information Administrator
Registered Health Information Technician
Project Management Professional
EPIC Certification
OnBase Certification
$26k-32k yearly est. 2d ago
Medical Coding Auditor
St. Luke's Hospital 4.6
Chesterfield, MO jobs
Job Posting We are dedicated to providing exceptional care to every patient, every time. St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for “Outstanding Patient Experience” by HealthGrades.
Position Summary:
Performs data quality reviews on patient records to validate coding appropriateness, missed secondary diagnoses and procedures, and ensures compliance with all coding related regulatory mandates and reporting requirements. Monitors Medicare and other payer bulletins and manuals and reviews the current OIG Work Plans for coding risk areas. Responsible for promoting teamwork with all members of the healthcare team. Performs all duties in a manner consistent with St. Luke's mission and values. This position is 40hrs/week and 100% remote.
Education, Experience, & Licensing Requirements:
Education: Associate degree in Health Services
Experience: 5 years of production coding experience or 5 years coding auditing experience. ICD-10-CM (including coding conventions and guidelines), CPT-4 (including coding conventions and guidelines), HCPCS, NCCI edits, and APC experience. Cerner and 3M/Solventum experience.
Licensure: RHIA, RHIT, or CCS certification
Benefits for a Better You:
Day one benefits package
Pension Plan & 401K
Competitive compensation
FSA & HSA options
PTO programs available
Education Assistance
Why You Belong Here:
You matter. We could not achieve our mission daily without the hands of our team. Our culture and compassion for our patients and team is a distinct reflection of our dynamic workforce. Each team member is focused on being part of something much bigger than themselves. Join our St. Luke's family to be a part of making life better for our patients, their families, and one another.
$44k-65k yearly est. 3d ago
Hospital Outpatient Coder II, FT, Days, - Remote
Prisma Health 4.6
Maryville, TN jobs
Inspire health. Serve with compassion. Be the difference.
Codes medical information into the organization billing/abstracting systems for multiple facilities. Performs moderate to complex Outpatient Surgery, Gastrointestinal (GI) Procedure and Observation coding by assigning International Classification of Diseases (ICD), Current Procedural Terminology (CPT) codes, and HCC codes. Performs Emergency Department, ambulatory clinic, diagnostic, and ancillary coding. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes.
Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health.Serve with compassion. Be the difference.
Codes moderate to complex Outpatient Surgery, and Observation records from clinical documentation as well as Emergency department, ancillary and ambulatory clinic records; assigns modifiers as appropriate.
Adheres to department standards for productivity and accuracy. Operates under the general supervision of HIM Coding leadership.
Reviews work queues daily to identify charts that need to be coded and prioritizes as per department-specific guidelines and within designated timelines. Follows up on on-hold accounts daily for final coding.
Responds to and follows up on priority accounts daily and any accounts assigned by Patient Financial services or Coding leader(s) for final coding.Communicates with leader when trending requests volumes impact productivity.
Queries physician or clinical area following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management Association (AHIMA) guidelines and established policy.
Applies ICD and CPT codes to the Emergency department, outpatient ambulatory clinic records and ancillary service records based on review of clinical documentation and according to Official coding guidelines; assigns modifiers.
Performs other duties as assigned.
Supervisory/Management Responsibilities
This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
Education - Certification Program, Associate degree or coding certificate through approved American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA) or other approved coding certification program.
Experience - Two (2) years of coding experience in an acute care or ambulatory setting. Outpatient coding experience
In Lieu Of
NA
Required Certifications, Registrations, Licenses
Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CCP-H), or Certified Outpatient Coder (COC).
Knowledge, Skills and Abilities
Demonstrates proficiency in utilizing official coding books as well as the electronic medical record and computer assisted coding/encoding software to facilitate code assignment.
Demonstrates continuous learning as evidenced by personally developed reference materials, online publications etc., to stay abreast of new and revised guidelines, practices and terminology, for reference and application.
Participates in on site, remote and/or external training workshops and training.
Ability to pass internal coding test.
Knowledge of electronic medical records and 3M or other Encoder System.
Ability to concentrate for extended periods of time; ability to solve problems with close attention to detail and to work and make decisions independently.
Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process.
Demonstrated competence in coding and correct extrapolation of official coding and select billing guidelines to specific coding situations.
Basic computer skills
Work Shift
Day (United States of America)
Location
Blount Memorial Hospital
Facility
7001 Corporate
Department
70017512 HIM-Coding
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
$31k-39k yearly est. 5d ago
Hospital Coder
Albany Medical Health System 4.4
Albany, NY jobs
Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements.
Essential Duties and Responsibilities
* Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines.
* Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines.
* Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
* Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
* Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
* Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim.
* Comply with comprehensive internal coding policies and procedures that are consistent with requirements.
* Attends coding meetings and roundtable sessions.
* Participates in daily huddles and LEAN problem-solving activities.
* Focused with no distractions while working and participating in meetings.
* Ensures camera on while attending Teams calls.
* Assists with organizing the shared drive for the medical coding department.
* Other duties as assigned by manager.
Qualifications
* High School Diploma/G.E.D. - required
* Prior experience in hospital medical coding - preferred
* Prior experience with 3M 360 and EPIC system - preferred
* Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency)
* Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency)
* Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency)
* Excellent written and verbal communication skills. (High proficiency)
* Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency)
* Detail-oriented and efficient while maintaining productivity.
* Coding certification / credential through AHIMA or AAPC and be in good standing. - required
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.
$55.9k-83.8k yearly Auto-Apply 45d ago
Medical Coding Specialist-Hybrid Position
Unity Health Care 4.5
Washington, DC jobs
Job DescriptionINTRODUCTION
Under the supervision of the Medical Billing Coding Manager, the coding specialist is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding specialist also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
DUTIES AND RESPONSIBILITIES
Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Supports the Senior Medical Billing and Coding Specialist to respond to audit findings and make applicable coding additions or corrections.
Registers and analyzes claims in the EMR system, including insurance verification and charge entry. Tracks and requests outstanding claims for assigned departments/facilities.
Reviews Medicare Local Coverage Determination (LCDs) and Medicare bulletin updates.
Utilizes the EMR system to run required daily/monthly/quarterly reports on claims entered.
Accepts assignments from management and maintain open communication with their manager to resolve quality and production issues.
Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third-party reimbursement agencies and special screening criteria.
Complies with the rules and regulations of Medicare billing including (but not limited to) incident to, teaching situations, shared visits, consultations, and global surgery.
Efficiently and accurately processes all types of claims utilizing broad based product or system knowledge to ensure timely payments are generated.
Maintains strict confidentiality regarding confidential conversations, documents, and files.
Supports the Senior Medical Billing and Coding Specialist to facilitates coding orientation for new providers.
Ability to read and abstract physician office notes and procedure notes to apply correct ICD-10-CM, CPT, HCPCS Level II and modifier coding assignments. Perform audits when necessary.
Performs other duties as assigned.
QUALIFICATIONS
High School diploma or GED required/associate's degree preferred.
Minimum of 5 years' coding experience using ICD-10-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions.
Coding certification is required through AAPC or AHIMA
KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION
Complete knowledge and understanding of PM and EMR workflows.
Must demonstrate ability to work independently with minimum supervision in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs.
Advanced knowledge of medical codes involving selections of most accurate and description code using the extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
Excellent oral, written, and telephone communication.
Working familiarity with the rules and regulation pertaining to the government/private/FQHC guidelines.
Ability to prioritize and manage multiple task with efficiency in dealing with multiple facilities.
Ability to handle a large volume of project receiving and researching claims.
Excellent computer skills, including Excel, Microsoft Word, etc.
SUPERVISORY CONTROLS
This position reports directly to the Coding Manager.
GUIDELINES
This position abides by all rules and regulations set forth by applicable licensing and regulatory bodies, as well as UHC policies and procedures.
PERSONAL CONTACTS
This position has primary contact with the clients and employees of Unity Health Care.
PHYSICAL DEMANDS
Refer to attached ADA requirements for the position.
WORK ENVIRONMENT
Refer to attached ADA requirements for the position.
OTHER SIGNIFICANT FACTS
Hours may include some evenings and/or Saturday work. While every effort is made to assign staff to one clinic site regularly, Unity may change the assigned clinic and/or site temporarily or permanently, depending upon the need.
RISKS
The position works involves everyday risk and discomforts, which require normal safety pre-caution typical of such places as offices, meetings, training room and other UHC health Care Sites. The work area is adequately lit, heated and ventilated. The position requires contact with staff at all levels throughout the organization. There are also external organization relationships that may be a part of the work of this individual. All medical services shall be provided according to medical accepted community standards of care. Shall provide evidence of recent (within the past twelve (12) months) health assessment that includes a PPD and/or chest x-ray results. Shall provide evidence of vaccination for Hepatitis A & B.
The statements contained herein describe the scope of the responsibility and essential functions of this position, but should not be considered to be an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other areas to cover absences or relief to equalize peak work periods or otherwise balance the workload.
$39k-50k yearly est. 19d ago
Medical Coding Specialist-Hybrid Position
Unity Health Care 4.5
Washington, DC jobs
INTRODUCTION
Under the supervision of the Medical Billing Coding Manager, the coding specialist is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding specialist also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
DUTIES AND RESPONSIBILITIES
Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Supports the Senior Medical Billing and Coding Specialist to respond to audit findings and make applicable coding additions or corrections.
Registers and analyzes claims in the EMR system, including insurance verification and charge entry. Tracks and requests outstanding claims for assigned departments/facilities.
Reviews Medicare Local Coverage Determination (LCDs) and Medicare bulletin updates.
Utilizes the EMR system to run required daily/monthly/quarterly reports on claims entered.
Accepts assignments from management and maintain open communication with their manager to resolve quality and production issues.
Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third-party reimbursement agencies and special screening criteria.
Complies with the rules and regulations of Medicare billing including (but not limited to) incident to, teaching situations, shared visits, consultations, and global surgery.
Efficiently and accurately processes all types of claims utilizing broad based product or system knowledge to ensure timely payments are generated.
Maintains strict confidentiality regarding confidential conversations, documents, and files.
Supports the Senior Medical Billing and Coding Specialist to facilitates coding orientation for new providers.
Ability to read and abstract physician office notes and procedure notes to apply correct ICD-10-CM, CPT, HCPCS Level II and modifier coding assignments. Perform audits when necessary.
Performs other duties as assigned.
QUALIFICATIONS
High School diploma or GED required/associate's degree preferred.
Minimum of 5 years' coding experience using ICD-10-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions.
Coding certification is required through AAPC or AHIMA
KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION
Complete knowledge and understanding of PM and EMR workflows.
Must demonstrate ability to work independently with minimum supervision in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs.
Advanced knowledge of medical codes involving selections of most accurate and description code using the extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
Excellent oral, written, and telephone communication.
Working familiarity with the rules and regulation pertaining to the government/private/FQHC guidelines.
Ability to prioritize and manage multiple task with efficiency in dealing with multiple facilities.
Ability to handle a large volume of project receiving and researching claims.
Excellent computer skills, including Excel, Microsoft Word, etc.
SUPERVISORY CONTROLS
This position reports directly to the Coding Manager.
GUIDELINES
This position abides by all rules and regulations set forth by applicable licensing and regulatory bodies, as well as UHC policies and procedures.
PERSONAL CONTACTS
This position has primary contact with the clients and employees of Unity Health Care.
PHYSICAL DEMANDS
Refer to attached ADA requirements for the position.
WORK ENVIRONMENT
Refer to attached ADA requirements for the position.
OTHER SIGNIFICANT FACTS
Hours may include some evenings and/or Saturday work. While every effort is made to assign staff to one clinic site regularly, Unity may change the assigned clinic and/or site temporarily or permanently, depending upon the need.
RISKS
The position works involves everyday risk and discomforts, which require normal safety pre-caution typical of such places as offices, meetings, training room and other UHC health Care Sites. The work area is adequately lit, heated and ventilated. The position requires contact with staff at all levels throughout the organization. There are also external organization relationships that may be a part of the work of this individual. All medical services shall be provided according to medical accepted community standards of care. Shall provide evidence of recent (within the past twelve (12) months) health assessment that includes a PPD and/or chest x-ray results. Shall provide evidence of vaccination for Hepatitis A & B.
The statements contained herein describe the scope of the responsibility and essential functions of this position, but should not be considered to be an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other areas to cover absences or relief to equalize peak work periods or otherwise balance the workload.
$39k-50k yearly est. Auto-Apply 60d+ ago
Coding Specialist II, Remote
Massachusetts Eye and Ear Infirmary 4.4
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 vascular surgery.
Job Summary
Summary:
Responsible for reviewing patient medical records after a visit and translating the information into codes that insurers use to process claims from patients. Duties include confirming treatments with medical staff, identifying missing information and submitting information to insurers for reimbursement. Participates in peer review to ensure accuracy and timeliness standards are maintained. Resolve complex coding questions that arise from team.
Does this position require Patient Care? No
Essential Functions
-Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits and to ensure that data complies with legal standards and guidelines.
-Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-9-CM and CPT codes.
-Provides technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines.
-Manages complex coding situations and supports peers through challenging questions.
-Peer reviews records for management to ensure accuracy of information.
-Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
-Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.
-Identifies reportable elements, complications, and other procedures.
Qualifications
Education
High School Diploma or Equivalent required
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
Experience
Medical Coding Experience 2-3 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.
- Strong understanding of coding guidelines, regulations, and industry best practices.
- Excellent leadership and team management skills, with the ability to motivate and develop coding team members.
- Strong communication and interpersonal skills to effectively collaborate with healthcare providers, coders, and other stakeholders.
- Strong problem-solving skills to address coding-related challenges and implement effective solutions.
- 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:
0100 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.
$21.8-31.1 hourly Auto-Apply 10d ago
Coding Specialist II, Remote
Massachusetts Eye and Ear Infirmary 4.4
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.
$21.8-31.1 hourly Auto-Apply 44d ago
Remote - Clinic/Outpatient Coder III
Mosaic Life Care 4.3
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.
$24.7-37.1 hourly 60d+ ago
Remote - Inpatient Coder II
Mosaic Life Care 4.3
Remote
Remote - Inpatient Coder II
Inpatient Coding
PRN 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.
$24.7-37.1 hourly 60d+ ago
Clinical Coder IV/Acute Care - Medical Records
Atrium Health 4.7
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
$43k-62k yearly est. 60d+ ago
Risk Adjustment Medical Coder
High Country Community Health 3.9
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
$38k-49k yearly est. 18d ago
Cardiology Coding Specialist (Remote)
Cardiology 4.7
California City, CA jobs
Summary Description:
Under general direction, this position will be responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Cardiology Coding Specialist works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition, this role monitors and analyzes coding performance at the section and business unit levels. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention.
Essential Duties and Responsibilities:
Review charts and capture all reportable services.
Coordinate with other coding staff to ensure all reportable services are captured and assigned to appropriate physician or ARNP.
Assign all appropriate ICD codes, CPT codes, and modifiers per ICD, CPT, and Medicare or commercial carrier published guidelines. Enter charges, review WQs to address edits/denials.
Review work queues in EMR and resolve coding issues for professional services for both hospital and clinic places of service.
Reconcile charges monthly to ensure capture of all reportable services.
Work with business office to resolve hospital billing questions/coding denials or concerns.
Assist employees and physicians in providing coding guidance. Ability to communicate effectively both orally and in writing.
Pull audit reports and back up documentation for internal audits.
Comply with all legal requirements regarding coding procedures and practices
Conduct audits and coding reviews to ensure all documentation is precise and accurate
Assign and/or review the sequence of all CPT and ICD 10 codes for services rendered
Collaborate with AR teams to ensure all claims are completed and processed in a timely manner
Support the team with applying expertise and knowledge as it relates to claim denials
Aid in submitting appeals with various payers about coding errors and disputes
Submit statistical data for analysis and research by other departments
Ability to identify PSI triggers or have working knowledge of PSI triggers which includes identifying and assigning co-morbidities and complications.
Ability to assign the appropriate DRG, discharge disposition code and principal DX codes
Serves as the liaison between revenue cycle operations and clients as it relates to charge capture documentation and reconciliation
Possesses a clear understanding of the physician revenue cycle
Oversees understands and communicates coding and charging processes for each client account based on their existing EHR system as it relates to office and hospital-based services which includes charge captures charge linkages to the CDM and charging processes.
Analyzes and communicates denial trends to Clients and operational leaders.
CPC or CCS coding credentials required. Cardiology experience preferred. EMR, eCW, Centricity, Epic, Encoder Pro or 3M experience highly desired.
Microsoft Office Skills:
Excel - Must have the ability to create and manage simple spreadsheets.
Word - Must be able to compose business correspondence.
License:
CPC, CCC or CCS (Required)
$57k-72k yearly est. 60d+ ago
BMS CODER - FT40 1st Shift
Wooster Community Hospital 3.7
Wooster, OH jobs
Job Description
The Coder is responsible to review, abstract and assign appropriate CPT/HCPC and ICD 10 codes to all BMS clinic visits as well as services provided by BMS providers in the hospital setting. The Coder is also responsible to assist the Revenue Cycle team. Under the direction of the System Director of Revenue Cycle, the Coder collaborates with the Providers, BMS Practice Managers, and COO to ensure timely and compliant billing for services provided.
Job Requirements
Minimum Education Requirement
Training/certification from an accredited coding/billing program. Must be certified upon hire, or successfully complete certification exam within 3 months of hire.
Minimum Experience Requirement
Three years' experience in medical office billing preferred.
Working knowledge of computers, billing and basic office software, especially Excel.
Ability to communicate with all levels of staff.
Analytical ability to detect trends in reimbursement/collections and to recommend or take corrective action.
Prior experience using encoder software.
Demands are typical of a position in a medical billing office, with extensive periods of sitting at a desk working on a computer. External applicants, as well as position incumbents who become disabled, must be able to perform the essential functions, either unaided or with the assistance of a reasonable accommodation, to be determined on a case-by-case basis.
Required Skills
Because medical billing duties are so varied, a flexible skill set is needed to perform them well. The following skills and personality traits are necessary to succeed in the field of medical billing/collections.
Ability to multi-task
Ability to understand insurance denials and payer remittances
Ability to understand different insurance policies/coverages
Ability to employ people skills to handle different personalities and situations
Essential Functions
Coder responsibilities below are subject to change as the job demands change:
Using encoder software to compliantly apply appropriate CPT/HCPC and ICD codes to claims.
Use claims submission software to review and resolve any rejected/denied or otherwise unpaid claims.
Promptly reports any trends or issues impacting timely coding and billing of claims to management team. Collaborates with team, including providers, practice managers and revenue cycle to resolve.
Act as a consultant for billing/coding questions from BMS practice staff.
Maintain coding credential and staying up to date on changing guidelines by obtaining an appropriate number of CEUs
Researching unpaid claims. Submitting appeals as necessary.
Researching and resolving credit balances.
Employee Statement of Understanding
I understand that this document is intended to describe the general nature and level of work being performed. The statements in this document are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
Monday thru Friday 8am to 430pm
Full Time FTE 40 hour per week
$57k-74k yearly est. 31d ago
Inpatient HIM Coder Analyst III-Remote within the state of Texas
Cook Children's Medical Center 4.4
Fort Worth, TX jobs
Department:
HIM-Coding
Shift:
First Shift (United States of America)
Standard Weekly Hours:
40
The HIM Coder Analyst III requires superior knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the Present on Admission (POA) indicators for accuracy. Primarily codes more complex and difficult inpatient medical records. Identifies and abstracts specified information from the patient medical record and enters data into the electronic health record system for billing and use in all types of CCHCS reporting. Performs extended length of stay coding for interim cycle billing. During inhouse interim coding, reviews for documentation opportunities and queries with CDIS to clarify confusing, incomplete or conflicting information and obtain any needed additional documentation in real time. Assists with coding outpatient surgery, observation outpatient ancillary clinic, specialty clinic and emergency room record visits as necessary. Minimum expected accuracy rate for all coding & DRG assignments is 95% or above. Communicates with physicians and other providers regarding documentation requirements and collaborates with Clinical Documentation Specialists or Quality Auditors on patient cases regarding documentation needs and requirements, and coding and DRG assignment accuracy. Maintains current knowledge of coding, DRG and documentation changes, rules and guidelines.
Education & Experience:
RHIA, RHIT required, with CCS highly desired, or CCS with two (2) year minimum full-time current and continuous ICD-10-CM/PCS hospital inpatient medical record coding and prospective payment system, experience with DRG assignment.
Outpatient observation and ambulatory surgery with CPT-4 coding and abstracting experience preferred.
Pediatric coding experience highly desired.
Technically competent and fluent knowledge in navigation of electronic health record applications, automated encoders, and other software applications and hardware required for job role required.
Experience using Microsoft Office Excel and Word highly desired.
Ability to work well independently and productively with minimal guidance and without direct supervision.
Must be highly detail oriented, have the ability to remain focused with good organization, interpersonal and communication skills.
Ability to maintain confidentiality.
Goal oriented, flexible and energetic.
Demonstrates superior coding skills, and critical thinking skills.
Ability to solve problems appropriately using job knowledge and current policies and procedures.
Demonstrated coding knowledge and proficiency is required through on-site skills assessment with a passing score of 90% accuracy prior to hire.
Certification/Licensure:
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) required. Required to provide current American Health Information Management Association (AHIMA) continuing education certification records.
About Us:
Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.
$50k-61k yearly est. Auto-Apply 60d+ ago
Health Information Management (HIM) Coder - Outpatient - PER DIEM
Rome Health 4.4
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.
$40k-52k yearly est. 8d ago
Digital Health Systems Co-op Student
Uc Health 4.6
Cincinnati, OH jobs
UC Health is hiring a Full Time Digital Health Systems Co-Op Student
Co-Op students participate in an organized co-op program sponsored by a university. The Co-op student will provide a variety of support tasks while participating in a mentoring and learning environment. The student may work in different functional areas within IS&T.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
Minimum Required: High School Diploma or GED
0 - 6 Months equivalent experience
The Co-Op is a current student in a University Sponsored program pursuing a degree. Typically, the co-op student has completed 1 year of college training before assuming a co-op work assignment
REQUIRED SKILLS AND KNOWLEDGE:
Gather and assess information pertaining to its reliability, reasonability and completeness;
Prepare summaries of that information using standard Microsoft Office tools (MS Excel, MS Word, etc.);
Have good writing skills, such that they are able to summarize their analyses and assessments;
Work with UC Health associates from all areas of the campus;
Have good inter-personnel skills.
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is an EEO employer.
System Development and Support
Assist in the development, implementation, and evaluation of digital health solutions that address specific patient needs, community health goals, or organizational objectives
Ensure all programs comply with healthcare regulations, security and quality standards
Project Support and Stakeholder Collaboration
Support UCH teams with user testing, troubleshooting, & refinement of digital health tools
Collaborate with clinicians, IT, & administrative staff to improve digital health experience
Data Collection and Reporting
Collect, review, analyze, interpret and communicate program data to track performance metrics and outcomes
Present regular reports for UCH DHS, and other stakeholders as assigned
Use data to identify areas for improvement and make evidence-based decisions to optimize program delivery
Compliance and Risk Management
Assist with ensuring programs adhere to healthcare laws, regulations, and accreditation standards
Identify potential risks and barriers related to program implementation and delivery, taking corrective actions when needed
Training and Development
Help create training materials and provide support to contribute to documentation of processes, workflows, and lessons learned
Other duties as assigned