Coder 2
Medical coder job at Fairview Health Services
Are you an expert Coding Specialist looking to join an outstanding organization? We at M Health Fairview are looking for a Coder 2 to join our Hospital Based ED coding team! This is a fully remote position that is approved for a 1.0 FTE (80 hours per pay period) on the day shift.
The Coder 2 analyzes clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient visits, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM, CPT-4, and HCPCs Coding Classification systems. Utilizes an electronic coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Coder 2's also resolves clinical documentation and charge capture discrepancies and provides feedback to providers on the quality of their documentation and charging.
Responsibilities
* Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards.
* Actively participates in creating and implementing improvements.
* Assigns ICD-10, CPT-4, and HCPCs codes to all diagnoses, treatments, and procedures, according to official coding guidelines.
* Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned.
* Extracts required information from electronic medical record and enters encoder and abstracting system.
* Follows-up on unabstracted accounts to assure timely billing and reimbursement.
* Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. May query physicians on documentation according to established procedures and guidelines.
* Meets departmental productivity and quality standards
* Complete projects as assigned.
* Timely and accurate work
* Contributes to the process or enablement of collecting expected payment
* Understands and adheres to Revenue Cycle's Escalation Policy.
Required Qualifications
* Certificate program in Coding or A.A./A.S. in HIM or Certificate with 1-3 years of healthcare experience (MA, HUC, Revenue Cycle)
* 1 year of coding experience
* Basic knowledge of Windows-based computer software. Epic and Microsoft Teams.
* Due to differences in scope of care, practice, or service across settings, the specific experience required for this position may vary.
* Registered Health Info Admin (RHIA) or Registered Health Info Tech (RHIT) or Certified Coding Specialist (CCS) or Professional Coder Cert (CPC) or Certified Coding Specialist - Professional (CCS-P) or Professional Coder- Hospital (CPC-H) or Certified Outpatient Coding (COC) or AAPC specialty certifications
Preferred Qualifications
* B.S./B.A. in HIM
* 2 years of coding experience
Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: *****************************************************
Compensation Disclaimer
An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
Auto-ApplyReimbursement Specialist
Medical coder job at Fairview Health Services
Provide superior customer service in person and on the phone to internal/external customers. Generate and monitor aging reports. Responsible for day-to-day functions of assigned accounts, to include but not limited to. Maintain and update billing activity. Ensure accurate and timely billing, collections, appeal of home infusion claims. Perform collection tasks to obtain payments. Analyze accounts for documentation, authorization, diagnosis, and all necessary information to determine the next step in the process. Process third party and patient remittances, including posting payments, credits, and adjustments. Timely and accurate application of payments on third party and patient accounts.
Responsibilties:
Provide superior customer service, in person and on the phone, to all insurance companies, Fairview entities, and patients.
* Communicate effectively, both written and verbal
* Communicate appropriate information to others according to established procedures to support day-to-day operations
Process home infusion claims accurately and timely.
* Review accounts for all needed information and communicate to correct departments to add information needed to ensure proper billing.
* Screen claims on-line or on paper for accuracy
* Obtain appropriate information to process claims
* Communicate and request necessary information from payers, patients, Fairview Department
Interpret and demonstrate accurate application of third-party payer and government payer contracts.
* Understand regulatory, HMO, PPO, Federal, State and other third-party payer requirements needed to prepare and or process claims
Generate and monitor aging reports on third party payers
* Communicate denials and Eligibility of Benefits (EOB's) to insurance company and patients
* Review aging reports that have reached certain aged categories (30,60,90 days,etc.)
* Maintain reports to 60 days
* Generate home infusion claims for resubmission for third party payer's outstanding balances.
Perform collection tasks to obtain payments from third party payers, government, and private accounts. Negotiate payment plan arrangement with delinquent patient accounts.
Prepare and request any credit or debit adjustments
* Research and refund patient or insurance company for overpayments
* Request adjustments on incorrectly processed claims
Review and process correspondence
* Patient orders
* Rejections/denials
* Medical record requests
* Itemized bills
* Clarification of detail on bill
Maintain and update patient accounts.
* Screen claims online and or on paper for accuracy
* Assist clients regarding billing questions and ensure appropriate resolution of problem(s).
* Document and maintain files
Process third party payers and patient remittances
* Interpret and demonstrate accurate application of third-party payer EOB's
* Understand Federal, State and other third-party payer requirements needed to prepare and process payments
* Document and maintain files to support reconciliation of amount posted to amount deposited.
* Post receipts within two working days after deposit.
* Prepare, scan and file documents in appropriate area
Required Qualifications
* High School Diploma/GED
* 1 year medical business office or pharmacy technician experience
* less than 1 year 6 months customer service or data entry experience
Preferred Qualifications
* Vocational/Technical Training or
* Associate Degree or Certified Medical Billing
* 3 years Three+ years medical billing or collection experience, Medicare, Medicaid, Third Party experience
* Pharmacy Technician MN Certified Pharmacy Technician
Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: *****************************************************
Compensation Disclaimer
An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
Auto-ApplySenior HB Coder-Remote
Rochester, MN jobs
Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
* Medical: Multiple plan options.
* Dental: Delta Dental or reimbursement account for flexible coverage.
* Vision: Affordable plan with national network.
* Pre-Tax Savings: HSA and FSAs for eligible expenses.
* Retirement: Competitive retirement package to secure your future.
Responsibilities
The Hospital Senior Coder is responsible for working collaboratively with various team members such as physicians and other hospital administration. This position coordinates with others as needed to ensure comprehensive and timely completion of hospital coding processes. This position will mentor, instruct and/or train other Hospital Coders in compliant coding standards (ICD-10 coding conventions, Official ICD-10 Reporting Guidelines, Coding Clinic, etc.). The Hospital Senior Coder reviews, interprets, and translates provider medical diagnostic and procedural information documentation into appropriate codes following hospital inpatient and/or outpatient claims and reporting requirements
Qualifications
High School diploma and 7 years hospital inpatient coding and/or hospital outpatient coding experience
OR
Associate's Degree and 5 years hospital inpatient coding and/or hospital outpatient coding experience required;
Bachelor's Degree in a healthcare related field preferred.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC).
Knowledge and experience with inpatient or coding guidelines and facility claim rules along with appropriate coding skills: ICD-10-CM diagnosis assignment, ICD-10-PCS procedure assignment, DRG assignment (e.g., MS-DRG and APR-DRG) for SOI and ROM, CPT procedure assignment, HCPCS assignment and/or modifier assignment. Experience with Experience with National Correct Coding Initiative (CCI) edits, National Coverage Determinations (NCD), Local Coverage Determinations (LCD), Coding Clinic, Coding Clinics for HCPCS, Current Procedural Terminology (CPT) Assistant coding guidelines, and official ICD-10 guidelines for Coding and Reporting. In-depth knowledge of medical terminology, anatomy and physiology, simple to complex disease processes, pathophysiology, and pharmacology. Knowledge and experience with principles, methods, and techniques related to compliant healthcare billing. Knowledge and experience with coding and billing requirements for services furnished in teaching settings. Knowledge of coding and billing requirements for provider based (PBB) facilities and critical access hospital (CAH). Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, is attentive to detail, demonstrate follow through skills and maintain a positive attitude. Registered Health Information Administrator (RHIA), Healthcare Financial Management Association (HFMA) Certification Preferred.
* This position is a 100% remote work. Individual may live anywhere in the US.
This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Exemption Status
Nonexempt
Compensation Detail
$30.25 -$45.01 / hour
Benefits Eligible
Yes
Schedule
Full Time
Hours/Pay Period
80
Schedule Details
Monday-Friday Business Hours
Weekend Schedule
N/A
International Assignment
No
Site Description
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the 'EOE is the Law'. Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Recruiter
Ronnie Bartz
Surgical Coder II-Remote
Rochester, MN jobs
**Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (************************************** - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
**Benefits Highlights**
+ Medical: Multiple plan options.
+ Dental: Delta Dental or reimbursement account for flexible coverage.
+ Vision: Affordable plan with national network.
+ Pre-Tax Savings: HSA and FSAs for eligible expenses.
+ Retirement: Competitive retirement package to secure your future.
**Responsibilities**
The Surgical Coder reviews, analyzes, and codes professional/physician medical record documentation to include, but not limited to, medical diagnostic and procedural information for various practices. This coder works collaboratively with surgeons to ensure the accuracy of the code sets on the surgical case.
There are currently 2 openings:
1. The preferred candidate will have professional surgical **coding experience in Urology and Gynecology.**
2. The preferred candidate will have professional surgical **coding experience in Plastic Surgery**
**Qualifications**
High School diploma and 6 years of physician/professional/procedural/surgical coding experience
OR
Associate's Degree and 4 years of physician/professional/procedural/surgical coding experience required; Bachelor's Degree preferred.
Minimum of 4 years of physician/professional/procedural/surgical coding experience.
1. Knowledge of professional/physician coding rules for specialized surgical professionals. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
2. In-depth knowledge of medical terminology, surgical procedures, disease processes, patient health record content and the medical record coding process.
3. Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections.
4. Knowledge of coding and billing requirements for services furnished in a teaching settings.
5. Knowledge of coding and billing requirements for provider based billing facilities.
6. Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, is attentive to detail, demonstrate follow through skills and maintain a positive attitude.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist - Physician (CCS-P) or a coding credential of a Certified Professional Coder (CPC) **required.**
Healthcare Financial Management Association (HFMA) Certification Preferred.
***This position is a 100% remote work. Individual may live anywhere in the US.**
****This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.**
_During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps._
**Exemption Status**
Nonexempt
**Compensation Detail**
$28.80 -$38.89 / hour
**Benefits Eligible**
Yes
**Schedule**
Full Time
**Hours/Pay Period**
80
**Schedule Details**
40 hours M-F
**International Assignment**
No
**Site Description**
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. (*****************************************
**Equal Opportunity**
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law" (**************************** . Mayo Clinic participates in E-Verify (******************************************************************************************** and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
**Recruiter**
Ronnie Bartz
**Equal opportunity**
As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
Hospital Inpatient Coder II-Remote
Rochester, MN jobs
**Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (************************************** - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
**Benefits Highlights**
+ Medical: Multiple plan options.
+ Dental: Delta Dental or reimbursement account for flexible coverage.
+ Vision: Affordable plan with national network.
+ Pre-Tax Savings: HSA and FSAs for eligible expenses.
+ Retirement: Competitive retirement package to secure your future.
**Responsibilities**
The HB IP Coder reviews, interprets, and translates provider medical diagnostic and procedural documentation into appropriate codes following hospital inpatient claims and reporting requirements. The HB Inpatient Coder initiates provider queries as needed to support accurate and comprehensive code assignment.
**Qualifications**
Associate degree required and a minimum of 3 years of relevant hospital inpatient coding experience.
Bachelor's Degree preferred.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) required.
Knowledge of hospital inpatient coding principles including Diagnosis Related Group (DRG) assignment logic, conditions affecting hospital quality measures such as Hospital Acquired Conditions, Present on Admission, and HCCs.
Ability to work concurrently in a fast-paced environment with identified productivity requirements and with individuals having diverse personalities and work styles.
Requires strong accuracy, attentiveness to detail and time management skills for translating complex medical documentation into diagnostic classification system codes.
In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process.
***This position is a 100% remote work. Individual may live anywhere in the US.**
****This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.**
_During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps._
**Exemption Status**
Nonexempt
**Compensation Detail**
$28.80 - $38.89/ hour
**Benefits Eligible**
Yes
**Schedule**
Full Time
**Hours/Pay Period**
80
**Schedule Details**
M-F
**International Assignment**
No
**Site Description**
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. (*****************************************
**Equal Opportunity**
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law" (**************************** . Mayo Clinic participates in E-Verify (******************************************************************************************** and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
**Recruiter**
Ronnie Bartz
**Equal opportunity**
As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
Hospital Inpatient Coder II-Remote
Rochester, MN jobs
Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
* Medical: Multiple plan options.
* Dental: Delta Dental or reimbursement account for flexible coverage.
* Vision: Affordable plan with national network.
* Pre-Tax Savings: HSA and FSAs for eligible expenses.
* Retirement: Competitive retirement package to secure your future.
Responsibilities
The HB IP Coder reviews, interprets, and translates provider medical diagnostic and procedural documentation into appropriate codes following hospital inpatient claims and reporting requirements. The HB Inpatient Coder initiates provider queries as needed to support accurate and comprehensive code assignment.
Qualifications
Associate degree required and a minimum of 3 years of relevant hospital inpatient coding experience.
Bachelor's Degree preferred.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) required.
Knowledge of hospital inpatient coding principles including Diagnosis Related Group (DRG) assignment logic, conditions affecting hospital quality measures such as Hospital Acquired Conditions, Present on Admission, and HCCs.
Ability to work concurrently in a fast-paced environment with identified productivity requirements and with individuals having diverse personalities and work styles.
Requires strong accuracy, attentiveness to detail and time management skills for translating complex medical documentation into diagnostic classification system codes.
In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process.
* This position is a 100% remote work. Individual may live anywhere in the US.
This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Exemption Status
Nonexempt
Compensation Detail
$28.80 - $38.89/ hour
Benefits Eligible
Yes
Schedule
Full Time
Hours/Pay Period
80
Schedule Details
M-F
International Assignment
No
Site Description
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the 'EOE is the Law'. Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Recruiter
Ronnie Bartz
Surgical Coder II-Remote
Rochester, MN jobs
Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
* Medical: Multiple plan options.
* Dental: Delta Dental or reimbursement account for flexible coverage.
* Vision: Affordable plan with national network.
* Pre-Tax Savings: HSA and FSAs for eligible expenses.
* Retirement: Competitive retirement package to secure your future.
Responsibilities
The Surgical Coder reviews, analyzes, and codes professional/physician medical record documentation to include, but not limited to, medical diagnostic and procedural information for various practices. This coder works collaboratively with surgeons to ensure the accuracy of the code sets on the surgical case.
There are currently 2 openings:
* The preferred candidate will have professional surgical coding experience in Urology and Gynecology.
* The preferred candidate will have professional surgical coding experience in Plastic Surgery
Qualifications
High School diploma and 6 years of physician/professional/procedural/surgical coding experience
OR
Associate's Degree and 4 years of physician/professional/procedural/surgical coding experience required; Bachelor's Degree preferred.
Minimum of 4 years of physician/professional/procedural/surgical coding experience.
1. Knowledge of professional/physician coding rules for specialized surgical professionals. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
2. In-depth knowledge of medical terminology, surgical procedures, disease processes, patient health record content and the medical record coding process.
3. Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections.
4. Knowledge of coding and billing requirements for services furnished in a teaching settings.
5. Knowledge of coding and billing requirements for provider based billing facilities.
6. Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, is attentive to detail, demonstrate follow through skills and maintain a positive attitude.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist - Physician (CCS-P) or a coding credential of a Certified Professional Coder (CPC) required.
Healthcare Financial Management Association (HFMA) Certification Preferred.
* This position is a 100% remote work. Individual may live anywhere in the US.
This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Exemption Status
Nonexempt
Compensation Detail
$28.80 -$38.89 / hour
Benefits Eligible
Yes
Schedule
Full Time
Hours/Pay Period
80
Schedule Details
40 hours M-F
International Assignment
No
Site Description
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the 'EOE is the Law'. Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Recruiter
Ronnie Bartz
Surgical Coder II-Remote
Rochester, MN jobs
The Surgical Coder reviews, analyzes, and codes professional/physician medical record documentation to include, but not limited to, medical diagnostic and procedural information for various practices. This coder works collaboratively with surgeons to ensure the accuracy of the code sets on the surgical case.
There are currently 2 openings:
The preferred candidate will have professional surgical coding experience in Urology and Gynecology.
The preferred candidate will have professional surgical coding experience in Plastic Surgery
High School diploma and 6 years of physician/professional/procedural/surgical coding experience
OR
Associate's Degree and 4 years of physician/professional/procedural/surgical coding experience required; Bachelor's Degree preferred.
Minimum of 4 years of physician/professional/procedural/surgical coding experience.
1. Knowledge of professional/physician coding rules for specialized surgical professionals. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
2. In-depth knowledge of medical terminology, surgical procedures, disease processes, patient health record content and the medical record coding process.
3. Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections.
4. Knowledge of coding and billing requirements for services furnished in a teaching settings.
5. Knowledge of coding and billing requirements for provider based billing facilities.
6. Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, is attentive to detail, demonstrate follow through skills and maintain a positive attitude.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist - Physician (CCS-P) or a coding credential of a Certified Professional Coder (CPC) required.
Healthcare Financial Management Association (HFMA) Certification Preferred.
*This position is a 100% remote work. Individual may live anywhere in the US.
**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Auto-ApplySenior HB Coder-Remote
Rochester, MN jobs
The Hospital Senior Coder is responsible for working collaboratively with various team members such as physicians and other hospital administration. This position coordinates with others as needed to ensure comprehensive and timely completion of hospital coding processes. This position will mentor, instruct and/or train other Hospital Coders in compliant coding standards (ICD-10 coding conventions, Official ICD-10 Reporting Guidelines, Coding Clinic, etc.). The Hospital Senior Coder reviews, interprets, and translates provider medical diagnostic and procedural information documentation into appropriate codes following hospital inpatient and/or outpatient claims and reporting requirements
High School diploma and 7 years hospital inpatient coding and/or hospital outpatient coding experience
OR
Associate's Degree and 5 years hospital inpatient coding and/or hospital outpatient coding experience required;
Bachelor's Degree in a healthcare related field preferred.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC).
Knowledge and experience with inpatient or coding guidelines and facility claim rules along with appropriate coding skills: ICD-10-CM diagnosis assignment, ICD-10-PCS procedure assignment, DRG assignment (e.g., MS-DRG and APR-DRG) for SOI and ROM, CPT procedure assignment, HCPCS assignment and/or modifier assignment. Experience with Experience with National Correct Coding Initiative (CCI) edits, National Coverage Determinations (NCD), Local Coverage Determinations (LCD), Coding Clinic, Coding Clinics for HCPCS, Current Procedural Terminology (CPT) Assistant coding guidelines, and official ICD-10 guidelines for Coding and Reporting. In-depth knowledge of medical terminology, anatomy and physiology, simple to complex disease processes, pathophysiology, and pharmacology. Knowledge and experience with principles, methods, and techniques related to compliant healthcare billing. Knowledge and experience with coding and billing requirements for services furnished in teaching settings. Knowledge of coding and billing requirements for provider based (PBB) facilities and critical access hospital (CAH). Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, is attentive to detail, demonstrate follow through skills and maintain a positive attitude. Registered Health Information Administrator (RHIA), Healthcare Financial Management Association (HFMA) Certification Preferred.
*This position is a 100% remote work. Individual may live anywhere in the US.
**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Auto-ApplyHospital Inpatient Coder II-Remote
Rochester, MN jobs
The HB IP Coder reviews, interprets, and translates provider medical diagnostic and procedural documentation into appropriate codes following hospital inpatient claims and reporting requirements. The HB Inpatient Coder initiates provider queries as needed to support accurate and comprehensive code assignment.
Associate degree required and a minimum of 3 years of relevant hospital inpatient coding experience.
Bachelor's Degree preferred.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) required.
Knowledge of hospital inpatient coding principles including Diagnosis Related Group (DRG) assignment logic, conditions affecting hospital quality measures such as Hospital Acquired Conditions, Present on Admission, and HCCs.
Ability to work concurrently in a fast-paced environment with identified productivity requirements and with individuals having diverse personalities and work styles.
Requires strong accuracy, attentiveness to detail and time management skills for translating complex medical documentation into diagnostic classification system codes.
In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process.
*This position is a 100% remote work. Individual may live anywhere in the US.
**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Auto-ApplyInpatient Coder - Per Diem
Los Angeles, CA jobs
General Information Press space or enter keys to toggle section visibility Onsite or Remote Fully Remote Work Schedule Monday - Friday, 6:00 AM - 3:00 PM PST; weekend availability may be required based on operational needs
Posted Date
12/11/2025
Salary Range: $59.8 - 74.35 Hourly
Employment Type
6 - Staff: Per Diem
Duration
Indefinite
Job #
27798
Primary Duties and Responsibilities
Press space or enter keys to toggle section visibility
Play a key role with a world-class health organization. Help ensure the operational efficiency of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.
You will be responsible for coding diagnoses and procedures for assigned cases. This will involve using your knowledge of UCLA, AHA - Coding Clinic, and AMA - CPT Assistant guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment, and procedures. You will assign ICD-10-CM/PCS and CPT/HCPCS codes for patients receiving our services while correctly assigning DRGs for all patients to assure accurate reimbursement and the highest quality data possible. You will abstract all coded data in a timely and accurate manner into the abstracting system.
Salary Range: $59.80/hourly - $74.35/hourly
Job Qualifications
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We're seeking an independent, detail-oriented, self-directed individual with:
* Associate degree in health information science, Bachelor's degree in health information management, or completion of courses in ICD-10-CM/PCS and CPT-4 coding
* CCS certification, required
* RHIA or RHIT, highly desired
* Three or more years of experience with surgical procedural and ambulatory care coding, preferred
* Five or more years of experience as an Inpatient Coder, preferably at an academic medical center
* Proficiency in ICD-10-CM, ICD-10-PCS, CPT-4/HCPCS and modifier usage
* Knowledge of APC payment methodologies, AHA Coding Clinic, and CPT Assistant
* Ability to orient and train new employees and students
* Understanding of all state and national reporting requirements
* Strong communication, interpersonal, and prioritizing skills
* Computer proficiency with Microsoft Office and 3M 360 Encompass software
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California, as well as the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
Coder 3 Remote Opportunity
Memphis, TN jobs
Coder-3
Available
Job Summary
Codes diagnoses and procedures of patient records and abstracting information for reimbursement, research, and to generate statistical data. Perform daily feedback and education to providers, staff and patients of BMG. Assist with education of current coding staff. Performs other duties as assigned.
Job Responsibilities
Job Responsibilities
Codes diagnoses and procedures of records.
Completes assigned goals.
Serves as a resource to physican office staff, clinical documentation specialist, case managers, etc.
Act as lead for the team, assisting in onboarding of new staff and/or education of more specialized workflows.
Assist in research of new speciality areas, new treatments in medicine, etc.
Work with new acquisitions on documentation improvement and medical necessity, including education.
Specifications
Experience
Description
Minimum Required
Preferred/Desired
Over one year of experience in physician /professional, outpatient surgery, and/or emergency department coding. Skill and proficiency in coding physician/professional outpatient (ancillary, emergency department, or outpatient surgery, etc) records utilizing ICD-9-CM and CPT-4 . Two years experience in an acute care facility, professional office or integrated health system. One year of documented successful physician education.
Education
Description
Minimum Required
Preferred/Desired
Skill and proficiency in coding physician/professional and outpatient (ancillary, emergency department, oupatient surgery, etc. ) records utilizing ICD-9-CM and CPT -4 through 5 years experience in an acute care facility, professional office or intergrated health system. Skill in communicating clearly and effectively using standard English in written, oral and verbal format to achieve high productivity and efficiency. Skill to write legibly and record information accurately as necessary to perform job duties. CPC, CPC-H, CPC-P, CCS, CCS-P
Associates degree
Training
Description
Minimum Required
Preferred/Desired
CPC, CPC-H, CPC-P, CCS, CCS-P,HCPCS, ICD-10, ICD-9, CPT-4
Special Skills
Description
Minimum Required
Preferred/Desired
Physician education, leadership, mentoring, workflow documentation
Licensure
Description
Minimum Required
Preferred/Desired
One of the following: Certified Coding Specialist (CSS), Certified Coding Specialist Physician (CCSP), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC/CPCH), Certified Professional Coder Payer (CPCP).
COC/CPCH;CPC-P ;CCS-P;CPC;CCS
Reporting Relationships
Does this position formally supervise employees? If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.
Reporting Relationships
No
Work Environment
Functional Demands
Label
Short Description
Full Description
Sedentary
Very light energy level
Lift 10lbs. box overhead. Lift and carry 15lbs. Push/pull 20lbs. cart
Light
Moderate energy level
Lift and carry 25-35lbs. Push/pull 50-100lbs. (ie. empty bed, stretcher)
Medium
High energy level
Lift and carry 40-50lbs. Push/pull +/- 150-200lbs. (Patient on bed, stretcher) Lateral transfer 150-200lbs. (ie. Patient)
Heavy
Very high energy level
Lift over 50lbs. Carry 80lbs. a distance of 30 feet. Push/pull > 200lbs. (ie. Patient on bed, stretcher). Lateral transfer or max assist sit to stand transfer.
Functional Demands Rating
Sedentary
Activity Level Throughout Workday
Physical Activity Requirements - Sitting
Continuous
Physical Activity Requirements - Standing
Occasional
Physical Activity Requirements - Walking
Occasional
Physical Activity Requirements - Climbing (e.g., stairs or ladders)
Occasional
Physical Activity Requirements - Carry objects
Occasional
Physical Activity Requirements - Push/Pull
Occasional
Physical Activity Requirements - Twisting
Occasional
Physical Activity Requirements - Bending
Occasional
Physical Activity Requirements - Reaching Forward
Occasional
Physical Activity Requirements - Reaching Overhead
Occasional
Physical Activity Requirements - Squat/Kneel/Crawl
Occasional
Physical Activity Requirements - Wrist position deviation
Frequent
Physical Activity Requirements - Pinching/fine motor activities
Occasional
Physical Activity Requirements - Keyboard use/repetitive motion
Continuous
Physical Activity Requirements - Taste or smell
Physical Activity Requirements - Talk or hear
Frequent
Sensory Requirements
Color Discrimination
Near Vision
Far Vision
Depth Perception
Hearing
Yes
Accurate
Accurate
Minimal
Moderate
Environmental Requirements - Blood-Borne Pathogens
Not Anticipated
Environmental Requirements - Chemical
Not Anticipated
Environmental Requirements - Airborne Communicable Diseases
Not Anticipated
Environmental Requirements - Extreme Temperatures
Not Anticipated
Environmental Requirements - Radiation
Not Anticipated
Environmental Requirements - Uneven Surfaces or Elevations
Not Anticipated
Environmental Requirements - Extreme Noise Levels
Not Anticipated
Environmental Requirements - Dust/Particular Matter
Anticipated
Environmental Requirements - Other
Auto-ApplySenior Professional Coder
Remote
#LI-Remote
Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.
All employees are eligible for medical coverage on their first day! In addition, upon hire all employees are eligible for a 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. Employees in a FT or PT status (40+ hours per pay period) will also be eligible for paid time off, life insurance, short term and long-term disability and the Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected. Additional benefits available to FT and PT employees include tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance and much more! Coverage is available to employees and their qualified dependents in accordance with the plans. Benefits may vary based on state law.
Job Overview
The Senior Professional Coder performs at an advanced level medical coding position and serves as an expert utilizing ICD-10 and CPT4 classification system coding to all diagnoses, treatments and procedures in all types of Hospital, Clinic and Ambulatory Surgical Center (ASC) locations at stated minimum performance levels. In addition, the Senior Professional Coder provides coding insight and guidance to clinical staff, Clinical Documentation Improvement (CDI), Professional Coder 1 and Professional Coder II positions as well as Revenue Cycle leadership.
Responsibilities
Responsibilities:
Assign and sequence all ICD-10; CPT 4; Healthcare Common Procedure Coding (HCPC) and modifier codes for services rendered accurately and completely
Reconcile correct coding edits and discrepancies prior to final coding
Maintain coding quality of 95% or higher while meeting established productivity requirements based on encounter type
Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
Identify trends in documentation deficiencies and communicates areas of improvement opportunities to leadership and/or providers
Acts as a key liaison for the physicians and clinical staff as it relates to coding and compliance
Interacts with physicians and other professional staff of documentation issues relating to coding data
Acts as a mentor to Coder I and Coder 2 staff
Provides system and workflow training to newly employed coders
Prepares and presents education in conjunction with the Revenue Integrity Professional Coding Educator
Primary contact for Revenue Cycle team throughout Shriners Hospitals for Children (SHC) system to assist with coding questions
Act as back up for Revenue Integrity Professional Coding Lead
This is not an all-inclusive list of this job's responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.
Qualifications
Minimum:
7 years of coding experience in inpatient/outpatient professional surgery
Experience with Surgery Coding guidelines, E/M Coding Guidelines, CPT Coding, ICD-10, Modifiers, HCPCS and CCI edits
Pediatric, orthopedic and/or injury coding experience
Experience with education and presentations
Functional knowledge of Medical Terminology
Functional knowledge of professional coding practice standards
Functional knowledge of MS Office
High School Diploma or GED
Current CCS-P (AHIMA) or CPC (AAPC)
Auto-ApplyRemote IP Coder Certified - HIM Inpatient Coding
Miamisburg, OH jobs
Job Details System Services | Miamisburg | Full-Time | First Shift Responsibilities & Requirements
Responsibilities:
Strong written and verbal communication skills.
Proficient in data entry, personal computers, knowledge of medical terminology, anatomy and physiology and disease processes.
Knowledge and experience with 3M and Epic clinical data system preferred.
Consistently follow coding guidelines and uses coding references to accurately select the appropriate principal diagnosis and procedure as well as secondary diagnoses and procedures.
Evaluates the quality of documentation of all accounts to identify incomplete or inconsistent documentation which affects coding, abstracting and charging and handles appropriately.
Identifies and monitors charging errors to reduce loss of revenue and any other issues regarding correct coding and reimbursement.
Coordinates and performs activities associated with processing and correcting rejected accounts.
Demonstrates knowledge of and adherence to department coding policies and compliance plan.
Maintains certification and demonstrates up-to-date job knowledge.
Requirements:
Associate or Bachelors' degree in Health Information Management with RHIT or RHIA certification and/or CCS certification.
RHIT/RHIA eligible will also be considered with coding/abstracting experience preferred (must sit for the exam at first available offering after completion of RHIT/RHIT program including passing their certification exam within one year of the first attempt.One to two years coding/abstracting experience in an acute care hospital with RHIT or RHIA certification or three to five years coding/abstracting experience in an acute care hospital with CCS certification.[Ohio, United States] Other
RHIT, RHIA, CCS
Hours/Shifts:
Full Time: Monday- Friday, 8:00 a.m.-5:00 p.m.
Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Auto-ApplyRemote Coder Certified - HIM Outpatient
Miamisburg, OH jobs
Job Details System Services | Miamisburg | Full-Time | First Shift Responsibilities & Requirements
• Responsible for coding and abstracting all outpatient patient records using ICD-10 and CPT/HCPCS coding rules, federal guideline and KHN guidelines. Supports hospital's accounts receivable goals through timely
processing of records and physician record completion activities.
• Impacts delivery of quality patient care and enhanced clinical decision making process.
• Supports clinical outcomes measurement and assessment process for service lines.
• Completes assigned duties and other related tasks.
• The list is not inclusive, duties may be modified to fulfill departmental needs or goals.
JOB REQUIREMENTS
Minimum Education
Associate degree or higher in Health Information Management - Preferred
Required Licenses
[Ohio, United States] Coder, Health Information
RHIT or RHIA certification and/or CCS certification.
Member of AHIMA - preferred
RHIT/RHIA eligible will also be considered with coding/abstracting experience preferred (must sit for the exam
at first available offering after completion of RHIT/RHIT program including passing their certification exam
within one year of the first attempt.)
Minimum Work Experience
Two years of experience coding in acute outpatient hospital setting
Required Skills
• Proficient in data entry using Microsoft Office Suite products.
• Proficient user of 3M CRS and CAC.
• Ability to navigate Epic EMR.
• Strong written and verbal communication.
• Application of medical terminology successfully translated to codeable language.
• Strength in anatomy and physiology associated with disease process.
• Knowledge of regulatory and governing body coding and billing guidelines.
ORGANIZATIONAL EXPECTATIONS
New Hire/Annual Competencies
• Accurate code assignment both ICD-10 CM and CPT.
• Accurate abstracting for all required fields.
• Meets productivity expectations.
• Meets performance in quality assurance with acceptable score.
• Accurately processes payer edits to promote clean claims for billing.
Preferred Qualifications
Certified Coding Specialist (CCS) credential
Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Auto-ApplyInpatient Coding Denials Specialist
Medical coder job at Fairview Health Services
The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the hospital/physician. Reviews and analyzes medical records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a working knowledge and stays abreast of ICD-10-CM and ICD-10-PCS, coding principles, medical terminology, governmental regulations, protocols and third-party payer requirements pertaining to billing, coding, and documentation. The Inpatient Coding Denials Specialist will also handle audit-related and compliance responsibilities. Additionally, this position will actively manage, maintain and communicate denial / appeal activity to appropriate stakeholders and report suspected or emerging trends related to payer denials. This position requires anticipating and responding to a wide variety of issues/concerns and works independently to plan, schedule and organize activities that directly impact hospital and reimbursement. This position will support change management by tracking and communicating trends and root cause to support future prevention with internal customers and stakeholders as well as with payers and third parties. This role is key to securing reimbursement and minimizing avoidable write off's.
Responsibilities
* Performs critical research and timely and accurate actions including preparing and submitting appropriate appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation of denials;
* Maintains extensive caseload of coding denials.
* Formulates strategy for prioritizing cases and maintains aging within appropriate ranges with minimal direction or intervention from Leadership.
* Acts as a liaison among all department managers, staff, physicians and administration with respect to coding denials issues.
* Assists with the development of denial reports and other statistical reports.
* Collaborates with Clinical Denials Nurse Specialist and Leadership in high-dollar claim denial review and addresses the coding components of said claims.
* Reviews insurance coding-related denials, including but not limited to: DRG downgrade, DRG Validation, Clinical Validation, diagnosis codes not supported, and/or general coding error denials.
* Responsible for reviewing assigned diagnostic and procedural codes against patient charts using ICD-10-CM and ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations.
* Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures.
* Contacts insurance carriers as appropriate to resolve claim issues
* Maintains payer portal access and utilizes said portal to assist in reviewing commercial medical policies
* Maintains working knowledge of regulatory and third-party policies and requirements to ensure compliance; remains current with applicable insurance carriers' timely filing deadlines, claims submission processes, and appeal processes and escalates timely filing requests to leadership.
* Assists with short-notice timely filing deadlines for accounts with coding issues.
* Provides feedback to the coding leadership team regarding coding denials.
* Compiles training material and educational sessions associated with coding denial-related topics and presents such educational materials. Collaboratively works with the coding education team & coding compliance team to assist in providing education to coders, physicians and mid-level providers.
* Monitors for coding trends, works collaboratively with the revenue cycle teams to prevent avoidable denials and reduce revenue loss.
* Identifies, quantifies and communicates risk concerns to leadership and supports mitigation efforts as appropriate. Demonstrates the ability to analyze coded data to identify areas of risk and provide suggestions for documentation improvement.
* Organization Expectations, as applicable:
* Fulfills all organizational requirements.
* Completes all required learning relevant to the role.
* Complies with and maintains knowledge of all relevant laws, regulations, policies, procedures and standards.
* Fosters a culture of improvement, efficiency and innovative thinking.
* Recommends process efficiencies, strategies for improvement and/or solutions to align with business strategies.
* Participate in process improvement meetings and/or discussions, recommending process efficiencies and/or strategies for denial prevention and revenue improvement.
* Performs all assigned functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Adheres to HIPAA compliance rules and regulations.
* Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision.
* Educates and mentors new employees through the on-boarding process.
* Adheres to productivity and quality standards.
* Performs other duties as assigned.
Required Qualifications
* 5 years hospital inpatient coding-related experience such as coding, auditing, abstracting, DRG assignment, Data Quality in coding denials
* Registered Health Info Admin or Registered Health Info Tech or Certified Inpatient Coder (CIC)or Certified Coding Specialist
Preferred Qualifications
* B.S./B.A. in HIM
* 1 year experience in managing and appealing denials
* 1 year expertise in reading and interpreting commercial payer medical policies
* 7+ years of hospital inpatient coding related experience such as coding, auditing, abstracting, DRG assignment, Data Quality in coding function type as required by position
* Epic experience in Resolute Hospital Billing
Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: *****************************************************
Compensation Disclaimer
The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
Auto-ApplyCertified Specialty Coder- Three Rivers Orthopedics
Pittsburgh, PA jobs
Three Rivers Orthopedics is seeking a Certified Specialty Coder to support 11 orthopedic surgeons specializing in areas including spine and foot/ankle at 200 Delafield Road, Suite 1040, Pittsburgh, PA 15215. This full-time position runs Monday-Friday, 8:00 AM-4:30 PM, with the potential for work-from-home flexibility after training
Responsibilities:
+ Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements.
+ Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices; prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation.
+ Perform all coding functions, based on staffing needs and/or department requirements.
+ Refer problem accounts to appropriate coding or management personnel for resolution.
+ Maintain daily productivity statistics and submits a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. Balance daily charges to data entry, forwarding results to departmental designee.
+ Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.
+ Assess current CPT guidelines as well as other applicable payer coding policy changes.
+ Lead, participate in and/or assist with departmental coding audits.
+ Identify incomplete documentation in the medical record and formulates a physician query to obtain missing documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process.
+ Incorporate into departmental procedures and communicates changes to coders and providers.
+ Adhere to internal department policies and procedures to ensure efficient work processes.
+ Maintain required CPC or CSS-P certification and continuing education by attending seminars, reviewing updated CPT Assistant guidelines and updated coding clinics.
+ Adhere to department time goal for final coding entry to prevent charge lags.
+ If applicable, abstract required medical and demographic information from the medical record and enters the data into the appropriate information system to ensure accuracy of the database. Responsible for correcting any data to be in error after reviewing the medical record and comparing with system entries.
+ Progress within the training period toward meeting departmental coding accuracy standards within the first year of employment by assigning correct principal diagnosis/procedure, complications and co-morbidities, and secondary diagnoses as reviewed by the designated trainer and/or the DRG Specialist. Coder should meet appropriate coding productivity standards within the time frame established by management staff.
+ Advise and instruct providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification.
+ Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions.
+ Demonstrate proficiency on billing system functionality as related to claim edit/charge review queues, as well as reimbursement denials.
+ Complete work assignments in a timely manner and understands the workflow of the department.
+ Train all new Coders to observe established coding guidelines and to utilize the appropriate billing system.
+ Investigate and resolve reimbursement issues, including denials, in a timely manner per department standards.
+ Analyze and interpret patient medical records within an area of medical/clinical specialty in order to determine amount and nature of billable services.
+ Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), encoders and electronic medical record repositories.
+ Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements.
+ High school diploma or GED is required.
+ Graduation from an approved Health Record Administration or Accredited Medical Record Technician program (RHIA/RHIT or eligible) or a certified coding program preferred.
+ 3 years of coding experience in the applicable medical specialty is required.
+ Advanced knowledge of medical coding and billing systems and regulatory requirements is required.
+ Ability to provide training, guidance, and operational support to lower level staff within area of specialty is required.
+ Experience and knowledge of accurate DRG and APC assignment is essential.
+ Ability to problem solve and be knowledgeable in advanced medical terminology, human anatomy/physiology, pharmacology, pathology and the principles of ICD-9-CM and CPT Classification Systems and DSM IV, if applicable.
+ Proficient computer skills, including working knowledge of MS Excel and MS Access, is preferred.Licensure, Certifications, and Clearances:
+ Certified Professional Coder (CPC)
+ Act 34UPMC is an Equal Opportunity Employer/Disability/Veteran
Certified Peer Specialist - TCM
Milwaukee, WI jobs
La Causa Social Services is dedicated to supporting individuals with complex mental health, developmental, and behavioral needs, and is seeking an empathetic, collaborative, and recovery-focused Certified Peer Specialist - TCM to join our Social Services team.
Why Join La Causa, Inc.?
Meaningful work supporting individuals and families on their recovery journey.
Collaboration with a dedicated network of mental health and community professionals.
Professional development and training opportunities.
Potential for career advancement within the organization.
Competitive benefits and paid leave including a day off for your birthday!
Your Role:
As a Certified Peer Specialist - TCM, you will use your personal lived experience with recovery to provide peer support and advocacy to individuals navigating mental health challenges. You will collaborate with consumers and care teams to empower personal growth, encourage engagement, and support long-term stability in the community.
What You'll Do:
Provide Supportive Services - Deliver person-centered, trauma-informed support through advocacy, transportation as needed, one-on-one meetings, and collaboration with care teams to help consumers work toward or maintain recovery.
Advocate for Consumers - Represent and support consumers in meetings, appointments, and within community systems to ensure their voices are heard and respected.
Empower Recovery - Use your lived experience to help individuals identify strengths, set goals, and connect with appropriate community resources and recovery supports.
Ensure Compliance - Follow all legal, organizational, and contractual policies, including documentation, audits, and program requirements.
Document and Report - Prepare, complete, and submit accurate and timely notes and required paperwork according to program timelines.
Promote Communication and Collaboration - Build and maintain strong relationships with consumers, team members, and external partners.
Fulfill Mandated Reporting Duties - Comply with all mandated reporting responsibilities related to child safety and welfare.
Engage in Professional Development - Attend meetings, training sessions, and professional development opportunities as directed.
Support the Team - Perform additional duties as assigned to contribute to the success of the program.
What We're Looking For:
Bachelor's degree from an accredited school in Social Work or related field (Required).
Master's degree from an accredited school in Social Work or related field (Highly preferred).
Certified as a State of Wisconsin Peer Specialist (Required).
OR successful completion of Certified Peer Specialist Training and must be certified within 12 months of hire.
Minimum of one (1) year of experience working in the community.
Bilingual (Spanish and English): Highly preferred.
Skills & Competencies:
Strong cultural competency and interpersonal relationship skills.
Excellent written and verbal communication abilities across diverse audiences.
Critical thinking and problem-solving skills with sound judgment.
Highly organized with the ability to manage multiple priorities.
Proficient in Microsoft Office Suite.
Reliable transportation, valid Wisconsin driver's license, state minimum auto insurance, and ability to meet La Causa, Inc. driving standards.
Must successfully complete and pass all required background checks, including an annual influenza vaccination.
Flexible schedule availability, including evenings and weekends as needed.
Work Environment:
Work performed in both office and field settings (travel required).
Local travel required; occasional state-wide travel as needed.
Flexible work hours including evenings or weekends based on program needs.
Regularly required to drive, stand, sit, reach, stoop, bend, and walk.
Frequent talking, seeing, and hearing; finger dexterity required.
Infrequent lifting, including files and materials.
Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
About La Causa, Inc.:
La Causa, Inc., founded in 1972, is one of Wisconsin's largest bilingual, multicultural agencies. Our mission is to provide children, youth and families with quality, comprehensive services to nurture healthy family life and enhance community stability. We have several divisions that provide vital services to the community including Crisis Nursery & Respite Center, Early Education & Care Center, La Causa Charter School, Social Services: Adult Services and Youth Services, and Administration. At the heart of our mission is the dedicated staff that welcomes all into Familia La Causa and serves the children and families of Milwaukee.
You can learn more about La Causa at
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Building Information Management Coordinator
Rochester, MN jobs
**Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (************************************** - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
**Benefits Highlights**
+ Medical: Multiple plan options.
+ Dental: Delta Dental or reimbursement account for flexible coverage.
+ Vision: Affordable plan with national network.
+ Pre-Tax Savings: HSA and FSAs for eligible expenses.
+ Retirement: Competitive retirement package to secure your future.
**Responsibilities**
The Mayo Clinic BIM Coordinator supports the enterprise BIM process along with regional BIM efforts. The BIM Coordinator will support the enterprise facilities BIM program, by organizing Revit files, working with various teams in updating BIM facility packages, managing and facilitating the sharing of all BIM data authored in the database BIM with all other data consumers. This role supports regional design teams by administering the Autodesk Construction Cloud tool set and general BIM/Revit support. The BIM Coordinator implements, manages, and supports the development of Revit model and BIM enterprise best practice for AEC project deliverables as defined by the enterprise BIM standards. Incorporates regional feedback into the Mayo Clinic enterprise BIM standards and best practices as needed. They function as BIM project managers for enterprise and regional design & construction projects in addition to BIM mentor for the regional planning and design teams. Responsible for content creation and maintenance of Mayo Clinic's enterprise Revit templates, Revit content management tool, seed files, regional templates, Autodesk Construction Cloud tools, and Revit database updates. Communicates with clients internally and externally for problem solving, BIM support and monitors project delivery to ensure compliance with the agreed upon strategy, enterprise standards, and processes. Provides technical staff with assistance performing difficult or complicated tasks and support for training for the departmental staff and end-users when needed. Coordinates the application of BIM technologies at the enterprise and regional level by working with all building and infrastructure disciplines. Creates clash detection reports and leads clash detection meetings with design teams for internal projects as needed. For external projects that require managing BIM deliverables the BIM coordinator will function as the owner's BIM representative. Coordinates with the Mayo Clinic Reality Capture team on all aspects of RECAP as related to BIM assets by coordinating the incorporation of point cloud data into the existing model packages. Assist, or fill in for, the BIM manager as needed. Leads the project-based BIM strategy call and kick-off meetings for projects and ensure the BIM models adhere to all Mayo Clinic enterprise BIM standards.
**Qualifications**
Preferred bachelor's degree in architecture, engineering, interior design, computer science, information technology or related field. Minimum 5 years of previous experience in a BIM-related role that represents a building owner operator, such as BIM Coordinator, BIM Technician, or similar position, with a proven track record in managing BIM processes within construction or architectural projects. Proficiency in BIM software platforms such as Autodesk Revit, AutoCAD, BIM 360, Autodesk Construction Cloud, and other industry-standard BIM tools. Strong understanding and practical experience with BIM methodologies, standards, and protocols. Experience with creation of Revit materials and renderings is required. Must demonstrate proficient experience of Revit family creation for architecture, and / or MEP and structural systems along with project design team support. Able to work collaboratively with diverse, multi-disciplinary stakeholders (design/operations/information systems/contractors) to develop consensus on enterprise BIM standards. Must possess strong interpersonal skills as well as strong verbal, written, and presentation skills. Able to define, prioritize and achieve specific goals and objectives with leadership competencies that include professionalism, honesty, vision, planning, and team building. Must be able to work in a team as well as independently, manage a variety of tasks simultaneously and efficiently with minimal direction, and work with a wide range of personalities and challenging situations. Prior experience in supervision and management preferred. Architecture, engineering, or interior design licensure is preferred. Autodesk and Autodesk REVIT certifications are preferred. Associated General Contractors of America Certificate of Management - Building Information Modeling preferred. Revit Certified Professional preferred (any discipline). AGC CM-BIM certification, Microsoft a plus.
**Exemption Status**
Exempt
**Compensation Detail**
$91,000 - $127,400 / year
**Benefits Eligible**
Yes
**Schedule**
Full Time
**Hours/Pay Period**
80
**Schedule Details**
Normal day time hours Monday-Friday with evening availability as needed to support department needs
**International Assignment**
No
**Site Description**
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. (*****************************************
**Equal Opportunity**
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law" (**************************** . Mayo Clinic participates in E-Verify (******************************************************************************************** and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
**Recruiter**
Stephanie Robinson
**Equal opportunity**
As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
Building Information Management Coordinator
Rochester, MN jobs
The Mayo Clinic BIM Coordinator supports the enterprise BIM process along with regional BIM efforts. The BIM Coordinator will support the enterprise facilities BIM program, by organizing Revit files, working with various teams in updating BIM facility packages, managing and facilitating the sharing of all BIM data authored in the database BIM with all other data consumers. This role supports regional design teams by administering the Autodesk Construction Cloud tool set and general BIM/Revit support. The BIM Coordinator implements, manages, and supports the development of Revit model and BIM enterprise best practice for AEC project deliverables as defined by the enterprise BIM standards. Incorporates regional feedback into the Mayo Clinic enterprise BIM standards and best practices as needed. They function as BIM project managers for enterprise and regional design & construction projects in addition to BIM mentor for the regional planning and design teams. Responsible for content creation and maintenance of Mayo Clinic's enterprise Revit templates, Revit content management tool, seed files, regional templates, Autodesk Construction Cloud tools, and Revit database updates. Communicates with clients internally and externally for problem solving, BIM support and monitors project delivery to ensure compliance with the agreed upon strategy, enterprise standards, and processes. Provides technical staff with assistance performing difficult or complicated tasks and support for training for the departmental staff and end-users when needed. Coordinates the application of BIM technologies at the enterprise and regional level by working with all building and infrastructure disciplines. Creates clash detection reports and leads clash detection meetings with design teams for internal projects as needed. For external projects that require managing BIM deliverables the BIM coordinator will function as the owner's BIM representative. Coordinates with the Mayo Clinic Reality Capture team on all aspects of RECAP as related to BIM assets by coordinating the incorporation of point cloud data into the existing model packages. Assist, or fill in for, the BIM manager as needed. Leads the project-based BIM strategy call and kick-off meetings for projects and ensure the BIM models adhere to all Mayo Clinic enterprise BIM standards.
Preferred bachelor's degree in architecture, engineering, interior design, computer science, information technology or related field. Minimum 5 years of previous experience in a BIM-related role that represents a building owner operator, such as BIM Coordinator, BIM Technician, or similar position, with a proven track record in managing BIM processes within construction or architectural projects. Proficiency in BIM software platforms such as Autodesk Revit, AutoCAD, BIM 360, Autodesk Construction Cloud, and other industry-standard BIM tools. Strong understanding and practical experience with BIM methodologies, standards, and protocols. Experience with creation of Revit materials and renderings is required. Must demonstrate proficient experience of Revit family creation for architecture, and / or MEP and structural systems along with project design team support. Able to work collaboratively with diverse, multi-disciplinary stakeholders (design/operations/information systems/contractors) to develop consensus on enterprise BIM standards. Must possess strong interpersonal skills as well as strong verbal, written, and presentation skills. Able to define, prioritize and achieve specific goals and objectives with leadership competencies that include professionalism, honesty, vision, planning, and team building. Must be able to work in a team as well as independently, manage a variety of tasks simultaneously and efficiently with minimal direction, and work with a wide range of personalities and challenging situations. Prior experience in supervision and management preferred. Architecture, engineering, or interior design licensure is preferred. Autodesk and Autodesk REVIT certifications are preferred. Associated General Contractors of America Certificate of Management - Building Information Modeling preferred. Revit Certified Professional preferred (any discipline). AGC CM-BIM certification, Microsoft a plus.
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