**About the Role:** We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts.
**Requirements and Qualifications:**
+ A minimum of 3 years of hands-on experience as an acute HIM inpatient medicalcoder in a hospital environment.
+ Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records.
+ In-depth understanding of supporting evidence requirements for accurate coding.
+ Practical experience using grouper software for MS-DRG and APR-DRG assignment.
+ Strong communication skills to interact effectively with the billing department regarding coding-related issues.
+ Stay abreast of the latest ICD-10-CM, ICD-10-PCS, HCPCS/CPT coding guidelines and updates.
+ Familiarity with 3M 360 or Optum HIM encoder software is preferred.
+ AHIMA Certified RHIA or RHIT certification is mandatory.
+ Associate's or Bachelor's degree in Health Information Management (HIM) is required.
**Responsibilities**
**Job Responsibilities:**
+ Collaborate closely with product management and engineering teams to contribute to the creation and improvement of AI models for medical coding.
+ Utilize your extensive knowledge in acute HIM inpatient medical coding to train and validate AI systems in extracting ICD-10-CM, ICD-10-PCS, and HCPCS/CPT codes, along with relevant modifiers from diverse clinical documentation.
+ Assist in the development of AI algorithms to generate precise MS-DRGs for accurate reimbursement.
+ Perform data collection, entry, verification, and analysis tasks to monitor and evaluate the performance of AI models against defined business goals.
+ Serve as a subject matter expert, ensuring the quality and integrity of medical coding data used in product development.
Disclaimer:
**Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.**
**Range and benefit information provided in this posting are specific to the stated locations only**
US: Hiring Range in USD from: $75,000 to $178,100 per annum. May be eligible for bonus and equity.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
Career Level - IC4
**About Us**
As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity.
We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all.
Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.
We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_************* or by calling *************** in the United States.
Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.
$75k-178.1k yearly 41d ago
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Coder lll -Inpatient Coder
Insight 4.4
Chicago, IL jobs
WE ARE INSIGHT: At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now!
These duties are to be performed in a highly confidential manner, following the mission, values, and behaviors of Insight Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians,
volunteers, and guests.
POSITION PURPOSE: Provides high level technical competency and subject matter expertise analyzing physician/provider documentation contained in assigned Complex Outpatient (CO) and/or Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Provides appropriate Medical Severity Diagnostic Related Groups (MS-DRG), Present on Admission (POA), Severity of Illness (SOI) & Risk of Mortality (ROM) assignments for Inpatient records and accurate APC assignments and all required modifiers for Complex Outpatient records.
Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes, MS-DRG, POA, SOI & ROM assignments and assignment of APC's and all required modifiers.
Assigns appropriate code(s) by utilizing coding guidelines established by:
The Centers for Medicare/Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ICD-PCS Official Guidelines for Coding and Reporting
American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification
American Medical Association (AMA) CPT Assistant for CPT codes
American Health Information Management Association (AHIMA) Standards of Ethical Coding
Revenue Excellence/RHM Organization coding policies
ESSENTIAL FUNCTIONS:
Knows, understands, incorporates, and demonstrates the Insight Hospital Mission, Vision, and Values in behaviors, practices, and decisions.
Adheres to Insight Health confidentiality requirements as they relate to the release of any individual or aggregate patient information.
Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs.
Codes Complex Outpatient or Inpatient utilizing encoder software and online tools and references, in the assignment of ICD, CPT, HCPCS codes, MS-DRG, POA, SOI & ROM assignments, APC assignment and all required modifiers.
Consults reference materials to facilitate code assignment.
Understands appropriate link of diagnosis to procedure.
Appends modifier(s) to procedure code or service when applicable.
Collaborates with HIM and Patient Financial Services in resolving billing and utilization issues affecting reimbursement.
Interprets bundling and unbundling guidelines (NCCI).
Interprets LCDs/NCDs and payer policies.
Tracks issues (i.e., missing documentation, charges or Inpatient queries that require follow-up to facilitate coding in a timely fashion).
Investigates claims denials and/or appeals as directed.
Consistently meets or exceeds coding quality and productivity standards.
Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
Identifies concerns and responsible for providing resolution of moderate to complex problems. Notifies appropriate leadership for resolution when appropriate.
Performs other duties as assigned by Leadership.
Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior
MINIMUM QUALIFICATIONS:
Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate's degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required. Bachelor's degree in Health Information Management (HIM) or related healthcare field is preferred.
Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA).
Two (2) years of current Complex Outpatient or Inpatient coding experience is required. Three (3) to five (5) years of current Complex Outpatient or Inpatient coding experienced preferred. Current experience doing remote coding is a plus.
Extensive comprehensive working knowledge of medical terminology, Anatomy and Physiology, diagnostic and procedural coding and MS-DRG or APC grouping. Current experience doing remote coding is a plus.
Current experience utilizing encoding/grouping software or CAC is preferred. Ability to utilize both manual and automated versions of the ICD, CPT, and HCPCS coding classification systems is preferred.
Ability to use a standard desktop and windows-based computer system, including a basic understanding of e-mail, internet, and computer navigation. Ability to use other software as required to perform the essential functions on the job. Familiarity with distance learning or using web-based training tools desirable.
Strong written and oral communication skills, that may be used either on-site or in virtual working environments. Ability to communicate effectively with individuals and groups representing diverse perspectives.
Ability to work with minimal supervision and exercise independent judgment.
Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload.
Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills.
Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions.
Ability to change and be flexible with work priorities. Strong problem solving- abilities.
Must be comfortable functioning in a virtual, collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Insight Hospital, Chicago.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITION:
Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles.
Must possess the ability to comply with Insight Hospital policies and procedures.
Must be able to spend majority of work time utilizing a computer, monitor, and keyboard.
Must be able to perform some lifting and/or pushing/pulling up to 20 pounds if applicable.
Must be able to work with interruptions and perform detailed tasks.
If applicable, involves a wide array of physical activities, primarily walking, standing, balancing, sitting, squatting, and reading. Must be able to sit for long periods of time.
Must be able to travel to Insight Hospital (10%) as applicable.
If applicable, telecommuting (working remotely), must be able to comply with Insight Hospital Working Remote Policy.
Benefits:
Paid Sick Time - effective 90 days after employment
Paid Vacation Time - effective 90 days after employment
Health, vision & dental benefits - eligible at 30 days, following the 1st of the following month
Short and long-term disability and basic life insurance - after 30 days of employment
Insight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
Insight is an equal opportunity employer and values workplace diversity!
$54k-74k yearly est. 60d+ ago
Healthcare Revenue Cycle / HIM Manager
Oracle 4.6
Boston, MA jobs
As a Healthcare Revenue Cycle / HIM Manager, your responsibilities will include: 1. Supporting a remote team for daily operations of the healthcare revenue cycle / healthcare coding department. 2. Identifying and implementing strategies to accelerate the revenue cycle by reducing accounts receivable days, improving cash flow, and enhancing profitability.
3. Managing account reconciliation, pre-collection, and post-collection activities to ensure accuracy and timeliness.
4. Identifying and resolving issues that affect revenue cycle performance using analytical and problem-solving skills.
5. Collaborating with cross-functional teams, including billing, coding, and clinical operations, to ensure the effectiveness of the revenue cycle process.
6. Training and mentoring staff on revenue cycle processes and best practices.
7. Staying abreast with the latest trends and regulations in the healthcare industry to ensure compliance and operational efficiency.
8. Developing and implementing policies and procedures to enhance operational efficiency and improve revenue cycle performance.
9. Providing regular reports and updates to senior management about the status and performance of the revenue cycle.
10. This individual will manage routine client meetings to obtain updates on initiatives and address any issues.
Qualifications:
The ideal candidate for the Healthcare Revenue Cycle / HIM Manager will have the following qualifications:
1. A minimum of 7 years of experience in healthcare revenue cycle management, including account reconciliation, pre-collection, and post-collection.
3. Strong knowledge of healthcare financial management and medical billing processes.
4. Exceptional analytical and problem-solving skills with a strong attention to detail.
5. Proficient in using healthcare billing software and revenue cycle management tools, with a strong background in Oracle Health (Cerner) software.
6. Strong leadership skills with the ability to manage and motivate a team.
7. Excellent communication and interpersonal skills with the ability to interact effectively with all levels of the organization.
8. Strong knowledge of federal, state, and payer-specific regulations and policies.
9. Ability to work in a fast-paced environment and manage multiple priorities.
**Responsibilities**
Analyzes business needs to help ensure Oracle's solution meets the customer's objectives by combining industry best practices and product knowledge. Effectively applies Oracle's methodologies and policies while adhering to contractual obligations, thereby minimizing Oracle's risk and exposure. Exercises judgment and business acumen in selecting methods and techniques for effective project delivery on small to medium engagements. Provides direction and mentoring to project team. Effectively influences decisions at the management level of customer organizations. Ensures deliverables are acceptable and works closely with the customer to understand and manage project expectations. Supports business development efforts by pursuing new opportunities and extensions. Collaborates with the consulting sales team by providing domain credibility. Manages the scope of medium sized projects including the recovery of remedial projects.
Disclaimer:
**Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.**
**Range and benefit information provided in this posting are specific to the stated locations only**
US: Hiring Range in USD from: $87,000 to $178,100 per annum. May be eligible for bonus and equity.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
Career Level - IC4
**About Us**
As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity.
We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all.
Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.
We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_************* or by calling *************** in the United States.
Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.
$87k-178.1k yearly 60d+ ago
Release of Information Specialist
Insight 4.4
Chicago, IL jobs
WE ARE INSIGHT: At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now! GENERAL SUMMARY: The Release of Information Specialist compiles, processes, maintains and reports medical records of patients. This is done in line with medical, administrative, ethical, legal, and regulatory standards of the health care system.
These duties are to be performed in a highly confidential manner, in accordance with the mission, values and behaviors of Insight Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.
DUTIES AND RESPONSIBILITIES:
Processing all release of information (ROI) requests, specifically medical record and billing requests, in a timely and efficient manner.
Ensure accuracy and provide clients with the highest quality product and customer service at all times
Safeguard and protect the patient's right to privacy by ensuring that only authorized individuals have access to the patient's medical information and that all releases of information are compliant with the request, authorization, hospital policy, and state and federal laws to include HIPAA regulations.
Prepares and processes requests for copies of medical records or other documents from patients, attorneys, insurance companies, and other parties involved in legal cases involving patients
Engages in direct customer service, when applicable, and must perform duties and conduct interpersonal relationships in a manner designed to project a positive image of the hospital.
Collaborates with the team leader, supervisor, manager and other members of the department to promote a harmonious work environment.
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
High School Diploma or GED required
A minimum of an associate's degree in healthcare related discipline desired
Knowledge, experience and/or training in accurate data entry, office equipment and procedures required; related experience healthcare environment is preferred
Ability to perform team-oriented job tasks with a conscientious awareness of detail and accuracy; effective organizational skills; ability to multitask effectively
Strong customer service skills
Effective communication skills (verbal and written)
Ability to know, understand, and apply Release of Information standards, policy and procedures and state and federal HIPAA regulations
Ability to read and comprehend simple, healthcare terminology
Problem solving and critical thinking skills
Must be able to speak, read, and write English; second language abilities a plus
Competent use of email, fax machines, copiers
Benefits:
Paid Sick Time - effective 90 days after employment
Paid Vacation Time - effective 90 days after employment
Health, vision & dental benefits - eligible at 30 days, following the 1st of the following month
Short and long-term disability and basic life insurance - after 30 days of employment
Insight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
Insight is an equal opportunity employer and values workplace diversity!
$42k-69k yearly est. 60d+ ago
CODING Apprenticeship
I.C.Stars 3.6
Chicago, IL jobs
Thank you for your interest in i.c.stars! YOUR FUTURE IN TECH, STARTS TODAY!
We are now accepting applications for the upcoming cycle. APPLY TODAY!
Who are we?:
i.c.stars |* is an immersive, technology-based leadership training program for promising young adults.
The basics:
Participants in the program start as *Interns. As an i.c.stars |* Intern, you participate in a 16-week paid training program, which includes:
project-based learning to build leadership skills and emotional intelligence
core technical skills training in coding: JavaScript, HTML, CSS, C#, and SQL
Networking opportunities with Executives and Professionals in the IT field
Career preparation and placement assistance
Upon completing the 16-weeks, *Interns graduate to become *Residents. Residency includes:
20 months of professional and social service support
Access to laptops and software
Business and Leadership Development events
College Enrollment Assistance
Our minimum requirements:
Minimum age 18 or older
Demonstrate financial need
GED recipient or High School graduate (Bachelor degree candidates are not eligible, some college accepted)
Have never attended a coding bootcamp in the past
Available to attend training from 8AM-8PM, Monday-Friday for 16 weeks
6 months previous full-time work experience preferred
Agree to a strict 'On Time, No Absence' policy
$35k-45k yearly est. Auto-Apply 60d+ ago
Health Information Technician
Insight 4.4
Chicago, IL jobs
WE ARE INSIGHT: At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now! GENERAL SUMMARY: The HIM technician usually works under the supervision of a supervisor, manager or director and uses both electronic and paper in organizing and maintaining patients' records. The HIM Technician collects and maintains a patient's healthcare information. This data may include medical history, diagnostic test results, reported and observed symptoms, examination results, and treatments. Health Information Technicians are also responsible for the accuracy, quality, and security of patient data. They must consult with healthcare providers to ensure all data is accurate, and for the purpose of updating patient information.
These duties are to be performed in a highly confidential manner, in accordance with the mission, values and behaviors of Mercy Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.
DUTIES AND RESPONSIBILITIES:
Ensure patients' files are properly maintained and can be retrieved upon request
Perform clerical tasks necessary for the proper maintenance of patients' medical records
Carry out correct reconciliation of all discharged records and ensure necessary follow up for missing documents
Prep, scan/verify, and index all patients' records within 24 to 48 hours of their discharge
Perform daily analysis of all Inpatient, Outpatient, Emergency department, and observation records following established operational guidelines and standards
Immediately enter deficiencies obtained from all records analyzed into the electronic Abstraction/Deficiency module after analysis
Ensure all documentation is properly signed, dated, and timed by the provider before patients' records are marked as completed
Scan or make photocopies of records; receive and send information through facsimile machine
Take telephone calls and provide answers to questions regarding patients' medical records.
Assists with the processing of requests for medical records when required.
Assists with the training of new hires in the HIM department based on job function.
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
Registered Health Information (RHIT) certification or a degree in Health information Technology is preferred.
Possess the minimum of High School diploma and three years' experience in health
Strong knowledge of medical terminology, anatomy and physiology, and pharmacology
Experience in data entry, retrieval and warehousing
Ability to use general office equipment, including telephone, fax machine, copy machine, scanner, and computer
Ability to communicate effectively, including reading, writing, and speaking
Ability to analyze, coordinate, observe, and make good decisions
Ability to work independently and perform excellently on the job without supervision
Ability to work under stressful conditions.
Insight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
Insight is an equal opportunity employer and values workplace diversity!
$30k-37k yearly est. 60d+ ago
Coding Specialist II
Insight 4.4
Chicago, IL jobs
WE ARE INSIGHT: At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now! GENERAL SUMMARY: Analyzes physician/provider documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, and Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers.
These duties are to be performed in a highly confidential manner, in accordance with the mission, values and behaviors of Mercy Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.
Duties and Responsibilities:
Assigns appropriate code(s) by utilizing coding guidelines established by:
The Centers for Medicare/Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ICD-PCS Official Guidelines for Coding and Reporting
American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification
American Medical Association (AMA) CPT Assistant for CPT codes
American Health Information Management Association (AHIMA) Standards of Ethical Coding
Insight Hospital coding policies
Knows, understands, incorporates, and demonstrates the Insight Hospital in behaviors, practices, and decisions.
Adheres to Insight Hospital confidentiality requirements as they relate to the release of any individual or aggregate patient information.
Proficiently navigates the patient health record and other computer systems/sources in determination of diagnoses procedures and modifiers to be coded and/or for APC assignment.
Codes Emergency Department and Outpatient Observation utilizing encoder software and online tools and references, in the assignment of ICD, CPT, and HCPCS codes and modifiers.
Consults reference materials to facilitate code assignment.
Understands appropriate link of diagnosis to procedure.
Appends modifier(s) to procedure code or service when applicable.
Collaborates with HIM and Patient Financial Services) in resolving billing and utilization issues affecting reimbursement.
Interprets bundling and unbundling guidelines (NCCI).
Interprets LCDs/NCDs and payer policies.
Tracks issues (i.e., missing documentation or charges) that require follow-up to facilitate coding in a timely fashion.
Investigates claims denials and/or appeals as directed.
Consistently meets or exceeds coding quality and productivity standards.
Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
Identifies concerns and is responsible for providing resolution of moderate to complex problems. Notifies appropriate leadership for resolution when appropriate.
Performs other duties as assigned by Leadership.
Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required. Bachelor's degree in Health Information Management (HIM) or related healthcare field is preferred.
Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) is required.
Two years of current acute care coding emergency department and observation or physician coding experience is required.
Current experience utilizing encoding/grouping software or CAC is preferred. Ability to utilize both manual and automated versions of the ICD, CPT, and HCPCS coding classification systems is preferred.
Ability to use a standard desktop and windows-based computer system, including a basic understanding of e-mail, internet, and computer navigation. Ability to use other software as required to perform the essential functions on the job. Familiarity with distance learning or using web-based training tools is desirable.
Well-developed written and oral communication skills that may be used either on-site or in virtual working environments. Ability to communicate effectively with individuals and groups representing diverse perspectives.
Ability to work with minimal supervision and exercise independent judgment.
Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload.
Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills. Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions. Ability to change and be flexible with work priorities. Strong problem-solving skills.
Must be comfortable functioning in a virtual, collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Insight-Chicago.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS:
Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles.
Must possess the ability to comply with Insight Hospital policies and procedures.
Must be able to spend the majority of work time utilizing a computer, monitor, and keyboard.
Must be able to perform some lifting and/or pushing/pulling up to 20 pounds if applicable.
Must be able to work with interruptions and perform detailed tasks.
If applicable, involves a wide array of physical activities, primarily walking, standing, balancing, sitting, squatting, and reading. Must be able to sit for long periods of time.
Must be able to travel to Insight Hospital (10%) as applicable.
If applicable, telecommuting (working remotely), must be able to comply with Insight Hospital Working Remote Policy.
BENEFITS:
Paid Sick Time - effective 90 days after employment
Paid Vacation Time - effective 90 days after employment
Health, vision & dental benefits - eligible at 30 days, following the 1st of the following month
Short and long-term disability and basic life insurance - after 30 days of employment
Insight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
Insight is an equal opportunity employer and values workplace diversity!
$54k-74k yearly est. 60d+ ago
Senior Inpatient HIM Coder
Oracle 4.6
Springfield, IL jobs
**About the Role:** We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts.
**Requirements and Qualifications:**
+ A minimum of 3 years of hands-on experience as an acute HIM inpatient medicalcoder in a hospital environment.
+ Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records.
+ In-depth understanding of supporting evidence requirements for accurate coding.
+ Practical experience using grouper software for MS-DRG and APR-DRG assignment.
+ Strong communication skills to interact effectively with the billing department regarding coding-related issues.
+ Stay abreast of the latest ICD-10-CM, ICD-10-PCS, HCPCS/CPT coding guidelines and updates.
+ Familiarity with 3M 360 or Optum HIM encoder software is preferred.
+ AHIMA Certified RHIA or RHIT certification is mandatory.
+ Associate's or Bachelor's degree in Health Information Management (HIM) is required.
**Responsibilities**
**Job Responsibilities:**
+ Collaborate closely with product management and engineering teams to contribute to the creation and improvement of AI models for medical coding.
+ Utilize your extensive knowledge in acute HIM inpatient medical coding to train and validate AI systems in extracting ICD-10-CM, ICD-10-PCS, and HCPCS/CPT codes, along with relevant modifiers from diverse clinical documentation.
+ Assist in the development of AI algorithms to generate precise MS-DRGs for accurate reimbursement.
+ Perform data collection, entry, verification, and analysis tasks to monitor and evaluate the performance of AI models against defined business goals.
+ Serve as a subject matter expert, ensuring the quality and integrity of medical coding data used in product development.
Disclaimer:
**Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.**
**Range and benefit information provided in this posting are specific to the stated locations only**
US: Hiring Range in USD from: $75,000 to $178,100 per annum. May be eligible for bonus and equity.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
Career Level - IC4
**About Us**
As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity.
We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all.
Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.
We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_************* or by calling *************** in the United States.
Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.