Medical Coder jobs at Houston Methodist

- 1111 jobs

Coding Charges & Denials Specialist - (Telecommute - Must reside in TX)
Houston Methodist 4.5
Medical coder job at Houston Methodist
Overview At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals process in a collaborative environment with revenue cycle management and clinical partners at various Houston Methodist facilities. This position will be responsible for working assigned specialties and combines clinical knowledge to reduce financial risk and exposure caused by front end claim edits and retrospective denial of payments for services provided. This position will collaborate with physicians, revenue cycle personnel, and payers to successfully clear front end claim edits, appeal clinical denials, and address customer service inquiries. Additionally, this position will collaborate with key stakeholders and assist in developing appeal strategies to include reference material for staff, letter templates, and regular feedback for revenue cycle coding staff; and functions as clinical subject matter expert related to coding denials and appeals. Houston Methodist Standard PATIENT AGE GROUP(S) AND POPULATION(S) SERVED Refer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity. HOUSTON METHODIST EXPERIENCE EXPECTATIONS Provide personalized care and service by consistently demonstrating our I CARE values: INTEGRITY: We are honest and ethical in all we say and do. COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs. ACCOUNTABILITY: We hold ourselves accountable for all our actions. RESPECT: We treat every individual as a person of worth, dignity, and value. EXCELLENCE: We strive to be the best at what we do and a model for others to emulate. Practices the Caring and Serving Model Delivers personalized service using HM Service Standards Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words) Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job Actively supports the organization's vision, fulfills the mission and abides by the I CARE values Responsibilities PEOPLE ESSENTIAL FUNCTIONS Communicates openly in a transparent and professional demeanor during all interactions with customers and co-workers while providing clear and concise communication of trending and findings to both front line team members and senior executives. Communicates to partners, revenue cycle staff, customers, and third party payers by telephone, in meetings, email, and other necessary forms of communication in a clear, effective, and timely manner while additionally providing proactive updates on initiatives that involve time and effort from peers and other employees. Functions as an educational liaison to clinical staff and revenue cycle staff as needed on payer denials, denial reason and trending, interpretation of payer manuals, medical policies, and local/national coverage determinations. SERVICE ESSENTIAL FUNCTIONS Performs data mining and reporting activities that identify net positive impactful opportunities in denials and adjustments for the individual facilities and the system. Works assigned claim edit and follow up work queues and meets the assigned productivity standards on a daily basis as well as assigned patient account work queues and responds with resolutions within the expected time frame. Acts as a liaison for issues affecting various teams (coding, revenue integrity, accounts receivable (AR) follow up, etc.) of the revenue cycle while also providing support when IT related or systematic changes are needed. QUALITY/SAFETY ESSENTIAL FUNCTIONS Analyzes data from various sources (medical records, claims data, payer medical policies, etc.), determines the causes for denials of payment and partners with management to implement strategies to prevent future denials. Integrates the payer medical policies, case specific medical documentation, and claims information into a concise appeal letter, including appropriate medical records submission. Performs timely review of medical records and remittances for denials in order to determine root cause and appropriateness. FINANCE ESSENTIAL FUNCTIONS Partners with revenue cycle leadership and peers and clinical operations to reduce denials. This includes reviewing claim edits and denials and/or inquiries referred from other departments and assists in identifying root causes. Investigates the validity of the reasons for the denials and determines the need for or feasibility of submitting appeals. Works with revenue cycle management and staff to ensure claim edit/denial trending data is accurate and that all metrics are reported appropriately including specific current procedural terminology (CPT)/healthcare common procedure coding system (HCPCS), denial reasons, and appeals. Monitors recovery of payments and trends to identify corrective measures needed to prevent future edits/denials. Analyzes claim edits/denials to identify new trends, opportunities, and educational feedback as needed. This includes, but not limited to, feedback to coding, clinical service areas, physicians, and other revenue cycle staff. Makes recommendations to revenue cycle leadership on operations and root causes and assists in development of strategies to avoid future claim edits and denials. GROWTH/INNOVATION ESSENTIAL FUNCTIONS Provides education to revenue cycle team and attends monthly billing staff meetings as appropriate. Pursues ongoing professional growth and development to maintain coding certification while remaining current on all coding and regulatory updates in addition to participating in educational activities. This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises. Qualifications EDUCATION High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) WORK EXPERIENCE Three years of certified coding experience Accounts receivable follow up experience preferred License/Certification LICENSES AND CERTIFICATIONS - REQUIRED Must have one of the following: • CCS - Certified Coding Specialist (AHIMA) • CPC - Certified Professional Coder (AAPC) KSA/ Supplemental Data KNOWLEDGE, SKILLS, AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles Demonstrates the ability to think critically, work independently, and be self-motivated for the role Experience with computer database management and Microsoft Office software SUPPLEMENTAL REQUIREMENTS WORK ATTIRE Uniform Yes Scrubs Yes Business professional Yes Other (department approved) No ON-CALL* *Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below. On Call* Yes TRAVEL** **Travel specifications may vary by department** May require travel within the Houston Metropolitan area Yes May require travel outside Houston Metropolitan area Yes Company Profile Houston Methodist Specialty Physician Group - As one of the nation's leading hospitals and academic medical centers Houston Methodist has brought together some of the nation's leading experts in multiple specialties to serve our patients. As part of Houston Methodist Specialty Physician Group (HMSPG), these specialists not only provide excellent clinical care, but are on the forefront of research, developing leading-edge technologies and treatments, and teaching the medical pioneers of tomorrow. This combination of clinical service, research and academics ensures patients have access to the latest in treatments and technologies while providing the best in comprehensive patient care. Established as a non-profit corporation and certified by the Texas State Board of Medical Examiners, HMSPG enables physicians to maintain autonomy with respect to their clinical practice while growing their practice within an academic environment.
$34k-44k yearly est. Auto-Apply 60d+ ago
Inpatient Coder
Houston Methodist 4.5
Medical coder job at Houston Methodist
At Houston Methodist, the Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. **PEOPLE ESSENTIAL FUNCTIONS** + Interacts and communicates effectively with members of the coding team and the appropriate stakeholders. + Participates and provides good feedback during coding section meetings and coding education inservices as well as takes initiative to assist others and shares knowledge with the appropriate stakeholders. **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer requests. Responds promptly and appropriately to requests to code or review coded accounts for accuracy. + Initiates queries with physicians to obtain or clarify diagnoses and/or procedures as appropriate, utilizing the established physician query process. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Maintains and achieves the highest standards of coding quality by assigning accurate/ICD-10-CM/ICD-10-PCS codes utilizing an electronic encoder application in accordance with hospital policy and regulatory body guidelines. + Maintains and achieves department standards of abstracting quality by reviewing accurate discharge disposition entered by nursing and corrects if necessary in order to achieve the highest quality of entered data. Assigns and enters physician identification number and procedure date correctly in the medical record abstracting system. + Reviews medical record documentation and abstracts data into the encoder and EPIC/Electronic Health Record (EHR) to determine principal or final diagnosis, co-morbid conditions and complications, secondary conditions and procedures. Utilizes all tools/ resources for accuracy. + Complies with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official guidelines. **FINANCE ESSENTIAL FUNCTIONS** + Utilizes time effectively. Consistently codes and abstracts at departmental standards of productivity while ensuring accuracy of coding. + Supports meeting organizational goal for Accounts Receivables (AR) associated with uncoded accounts. + Maintains coding timeframes within established departmental standards by ensuring all work items assigned to the coding queues are processed in a timely manner. **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Critically evaluates her or his own performance, accepts constructive criticism, and looks for ways to improve. + Displays initiative to improve relative to job function. Contributes ideas to help improve quality of coding data and abstracting data. This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises. **EDUCATION** + Associate's degree or higher in a CAHIIM accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree **WORK EXPERIENCE** + One year of relevant inpatient coding experience or successful completion of the Houston Methodist Coding Apprentice Program or Outpatient to Inpatient Coder Transition Program **LICENSES AND CERTIFICATIONS - REQUIRED** + Must have one of the following: + - RHIT - Certified Health Information Technician (AHIMA) + - RHIA - Registered Health Information Administrator (AHIMA) + - CCS - Certified Coding Specialist (AHIMA) **KNOWLEDGE, SKILLS, AND ABILITIES** + Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations + Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security + Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles + Knowledge of coding classification systems, DRG and APC systems, official coding guidelines and coding compliance + Knowledge of an electronic medical record and imaging systems preferred + Working knowledge of medical terminology, anatomy and physiology + Proficiency with electronic encoder application preferred + Extensive PC knowledge - must be able to work effectively in common office software, coding software and abstracting systems **SUPPLEMENTAL REQUIREMENTS** **WORK ATTIRE** + Uniform No + Scrubs No + Business professional Yes + Other (department approved) No **ON-CALL*** _*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below._ + On Call* No **TRAVEL**** _**Travel specifications may vary by department**_ + May require travel within the Houston Metropolitan area Yes + May require travel outside Houston Metropolitan area Yes **Company Profile:** Houston Methodist is one of the nation's leading health systems and academic medical centers. Houston Methodist consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center, and seven community hospitals throughout the greater Houston area. Houston Methodist also includes an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, Houston Methodist employs more than 27,000 employees and is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care. Houston Methodist is an Equal Opportunity Employer.
$34k-44k yearly est. 38d ago
Outpatient Coding Quality Educator Specialist - Coding (req - 30697)
Lakeland Regional Health-Florida 4.5
Lakeland, FL jobs
Outpatient Coding Quality Educator Specialist - Coding 30697 Active - Benefit Eligible and Accrues Time Off Work Hours per Biweekly Pay Period: 80.00 Shift: Monday Friday Pay Rate: Min $63,793.60 Mid $79,747.20 Under the direction of the facility Coding and Reimbursement Manager, conducts coding quality reviews and audits of chart documentation to assess accuracy, ensure compliance with federal and payer policies, and identifies areas for improvement for hospital outpatient coding. Develops and delivers training on coding accuracy and compliance, staying updated on regulations and providing expert guidance to coders. Provides ongoing coding education and training to coding team and serves as mentor to all new coding team members. Serves as a subject matter expert and resource for coders, providers, and other staff on coding questions, regulatory changes, and best practice. Prepares reports of findings and meets with coders and Coding Leadership to provide education and training on accurate coding practices and compliance issues. Has thorough knowledge of acute care facility guidelines, modifiers, sequencing rules and the NCCI (National Correct Coding Initiative) edits, OCE (Outpatient Code Editor) edits, Official Guidelines for Coding and reporting for ICD-10-CM/PCS, CPT-4, and HCPCS coding conventions, APC payment classifications and Medicare Conditions of Participation. Will assist the Coding and Reimbursement Manager on preparing presentations and/or interdepartmental feedback. Responsible for conducting coding and billing training programs for billing and coding specialists. Other duties will include implementing coding department policies and procedures and assisting with reviewing and appealing coding denials. Position Responsibilities People At The Heart Of All That We Do Fosters an inclusive and engaged environment through teamwork and collaboration. Ensures patients and families have the best possible experiences across the continuum of care. Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created. Safety And Performance Improvement Behaves in a mindful manner focused on self, patient, visitor, and team safety. Demonstrates accountability and commitment to quality work. Participates actively in process improvement and adoption of standard work. Stewardship Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities. Knows and adheres to organizational and department policies and procedures. Standard Work: Outpatient Coding Quality Educator Specialist Actively participates in team development, achieving dashboards, and in accomplishing departmental goals and objectives. Performs internal quality assessment reviews on outpatient facility coders to ensure compliance with national coding guidelines and the LRH coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. Helps to coordinate and direct the day-to-day coding educational activities. Facilitates and provides coding educational classes/presentations to staff, as required/when needed. Communicates outcomes to the coding team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. Responsibilities also include assisting Coding Leadership in root cause analysis of coding quality issues, performing account reviews, and preparing training documents to assist with coding quality action plans. Assists in the review, improvement of processes, education, troubleshooting and recommend prioritization of issues. Researches coding opportunities and escalates as needed. Communicates Coding topics and/or question trends to Coding Leadership for global education. Prepares and presents coding compliance status reports to the Coding and Reimbursement Manager and Health Information Management AVP. Assists in ensuring coding staff adherence with coding guidelines and policy. Demonstrates and applies expert level knowledge of medical coding practices and concepts. Coaches and mentors coding staff as they develop and grow their coding skills. Provides skilled coding support through regularly scheduled coding meetings and as the need arises. Provide one-on-one coaching and support to coding professionals, offering constructive feedback and guidance to improve coding accuracy and documentation practices. Assists Coding Leadership with outpatient coding denials. Create educational materials, such as manuals, handouts, and multimedia presentations, that effectively communicate complex coding concepts and guidelines. Orients, develops and coordinates on-the-job training of instructing them on systems and policies and procedures in accordance to coding compliance guidelines. Experience essential: 5+ years acute care hospital outpatient coding experience and/or coding auditing 5-10 years of educational experience in a facility or consulting setting. Certification essential: CCS, CPC, RHIT, or RHIA Certification preferred: RHIA About Us: Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 910 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits. To apply please send your resume to: Tiffany Hanson at: Tiffany.Hanson@my LRH.org
$63.8k-79.7k yearly 2d ago
Coder II - Outpatient - Coding & Reimbursement
Lakeland Regional Health-Florida 4.5
Lakeland, FL jobs
Details Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits. Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally. Active - Benefit Eligible and Accrues Time Off Work Hours per Biweekly Pay Period: 80.00 Shift: Flexible Hours and/or Flexible Schedule Location: 210 South Florida Avenue Lakeland, FL Pay Rate: Min $19.37 Mid $24.22 Position Summary Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes. Position Responsibilities People At The Heart Of All That We Do Fosters an inclusive and engaged environment through teamwork and collaboration. Ensures patients and families have the best possible experiences across the continuum of care. Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created. Safety And Performance Improvement Behaves in a mindful manner focused on self, patient, visitor, and team safety. Demonstrates accountability and commitment to quality work. Participates actively in process improvement and adoption of standard work. Stewardship Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities. Knows and adheres to organizational and department policies and procedures. Standard Work Duties: Coder II - Outpatient Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment. Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement. Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers. Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines. Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames. Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities. Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily. Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections. Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections. Competencies & Skills Essential: Computer Experience, especially with computerized encoder products and computer-assisted coding applications. Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision. Knowledge of anatomy and physiology, pharmacology, and medical terminology. Qualifications & Experience Essential: High School or Equivalent Nonessential: Associate Degree Essential: High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college. Other information: Certifications Essential: CCS Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA). Experience Essential: 2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.
$43k-53k yearly est. 4d ago
Clinical Reimbursement Specialist
Life Care Centers of America 4.5
Knoxville, TN jobs
The Clinical Reimbursement Specialist ensures correct monetary reimbursement for any services offered to patients and residents covered by insurance programs by reviewing patient records and clinical care programs. in accordance with all applicable laws, regulations, and Life Care standards. Education, Experience, and Licensure Requirements Registered nurse with an active state license and MDS and RAI experience. Specific Job Requirements Make independent decisions when circumstances warrant such action Knowledgeable of practices and procedures as well as the laws, regulations, and guidelines governing functions in the post acute care facility Implement and interpret the programs, goals, objectives, policies, and procedures of the department Perform proficiently in all competency areas including but not limited to: patient rights, and safety and sanitation Maintains professional working relationships with all associates, vendors, etc. Maintains confidentiality of all proprietary and/or confidential information Understand and follow company policies including harassment and compliance procedures Displays integrity and professionalism by adhering to Life Care's Code of Conduct and completes mandatory Code of Conduct and other appropriate compliance training Essential Functions Exhibit excellent customer service and a positive attitude towards patients Assist in the evacuation of patients Demonstrate dependable, regular attendance Concentrate and use reasoning skills and good judgment Communicate and function productively on an interdisciplinary team Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours Read, write, speak, and understand the English language An Equal Opportunity Employer
$44k-52k yearly est. 2d ago
Remote - Clinic/Outpatient Coder III
Mosaic Life Care 4.3
Remote
Remote - Clinic/Outpatient Coder III Outpatient Coding PRN Status Variable Shift Pay: $24.74 - $37.11 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. Expected to be proficient in assigning ICD-10-CM and/or CPT codes for following types of services: Outpatient: Complex Surgeries, Observations (non-obstetric), Interventional radiology, radiation oncology and/or non-complex inpatient coding encounters. Clinic coder: Either proficient in coding for all non-surgery specialty areas, primary care, or complex surgeries. This position works under the guidance and supervision of the HIM Outpatient APC and Clinic Coding Manager and is employed by Mosaic Health System. Codes procedures and diagnoses using the ICD-10-CM, CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Communicates with providers, querying providers to ensure the highest level of specificity is provided in documentation. May assist in training of newly hired coders. Caregiver may work in conjunction with Patient Financial Services to verify and modify charges and coding to ensure accuracy of supporting documentation, payer rules and correct coding. Working reports for clean-up, auditing services, edits, and denials. Ensures data accuracy of State HIDI data by responding to edits received. Performs other duties as assigned. Must have coding education, HS Diploma and Medical Terminology and Anatomy and Physiology Required to obtain CCS - Certified Coding Specialist or RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CPC and/or CCSP - Certified Professional Coder within 180 days of employment. Must also obtain COC - Certified Outpatient Coding within 180 days of employment. Five years experience in a Health Information Services department performing a job that requires detail, and familiarity with patient medical record preferred.
$24.7-37.1 hourly 60d+ ago
Remote - Inpatient Coder II
Mosaic Life Care 4.3
Remote
Remote - Inpatient Coder II Inpatient Coding Full Time Status Day Shift Pay: $24.74 - $37.11 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. This position is responsible for assigning ICD-10-CM and ICD-10-PCS codes for inpatient and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic, anatomy and physiology. This position works under the supervision of the Manager and is employed by Mosaic Health System. Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines and organizational compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Completes complex coding assignments for reimbursement, research and compliance with Federal and State regulations. Researches coding guidelines. Reviews and appeals coding denials. Educates/Communicates with providers, querying providers to ensure that optimal clinical documentation is provided to demonstrate the severity and details of the patient's illness in the medical record. Coordinates/Communicates with departments including clinical departments, Quality Improvement, Care Management, Patient Financial Services to ensure accuracy and timeliness of coding. Ensures data accuracy by responding to coding edits received. Cross-trained and able to complete one type of outpatient facility coding in addition to inpatient coding. Example: Emergency Department, Observation, Referral. Mentors and assists with training coders. Completes analysis by utilizing reports, record reviews, etc. Other duties as assigned. Must have coding education. Associate's Degree or higher in Health Information Management / Medical Records required. CCS - Certified Coding Specialist, RHIA - Registered Health Information Administrator, or RHIT - Registered Health Information Technician required. Three years experience in coding in an acute care setting required.
$24.7-37.1 hourly 60d+ ago
Home Health and Hospice Coder
Lorian Health 3.9
San Diego, CA jobs
Job Details LHSD - SAN DIEGO, CA Fully Remote $27.00 - $31.00 HourlyDescription Who We Are: Lorian Health is a home health and hospice agency seeking energetic candidates to join our team of skilled professionals. Come join a home health agency that is thoughtful, generous, and family-oriented, placing focus on taking the best care of our patients and our employees! Lorian Health sets the highest quality standards for home health services in existence today. Foremost of these, is our belief in equanimity in regard to the treatment of all our patients. Lorian Health is committed to fostering a socially responsible environment within our organization and community and is determined to provide the highest caliber of health care for our patients and their families. What We Offer: We offer a comprehensive employee benefits package that includes, but is not limited to: Health, Dental, Vision, 401K with company match Competitive pay Paid vacation, holidays, and sick leave Full time includes company paid health insurance, dental insurance, vision insurance, paid life insurance, supplemental insurance and 401(k) plan with 4% match, as well as annual accrual of 10 vacation days,10 sick days, 9 holidays. Join our innovative team to help patients empower themselves to improve self-care. Qualifications Requirements: Must live in Pacific, Mountain or Central Time Zones Completion of coding specific coursework Current ICD-10 Coding Certification (HCS-D, BCHH-C, or HCS-H) Minimum of 1 year previous experience with Home Health ICD-10 coding with verified employment/experience are required. Minimum of 1 year previous experience with Hospice ICD-10 coding with verified employment/experience are required. Knowledge of and ability to follow appropriate skilled documentation under Medicare guidelines and conditions of participation. Knowledge of Patient Driven Grouping Models (PDGM) Knowledge of insurance reimbursement procedure. Ability to maintain confidentiality of records and information. Ability to be flexible, follow verbal and written instruction while working in a team oriented environment. Detail oriented with critical thinking and strong clinical judgement and analytical skills. Ability to demonstrate flexibility in response to unexpected changes in work volume and work schedule. Excellent interpersonal relation skills including active listening, conflict resolution, and team building. Communicates effectively with the clinical and office staff involved in any given case in a constructive, goal directed, and professional manner Excellent computer skills to include Microsoft applications (i.e. Word/Excel) and ability to type at least 40 wpm Preferred: OASIS certification (COS-C, HCS-O) Background on OASIS E Graduate of Bachelor is Science in health field Experience with HCHB software
$55k-68k yearly est. 60d+ ago
Certified Medical Coder
Roots Community Health Center 3.5
Oakland, CA jobs
Temporary Description The Certified Medical Coder represents Roots Community Health Center, working as part of a team in a highly visible setting. This position provides support to the Director of Billing, Billing and Coding Administrator. This position works in collaboration with the providers, billing specialist and finance team, using efficient medical coding. The Certified Medical Coder provides coding audits of all billing providers within the practice based on documentation guidelines, Medicare Guidelines and coding initiatives. As the coder audits and interprets patient medical records, transcriptions, test results, and other documentation, we'll rely on the coder to ask questions, make coding recommendations, research billable procedures and codes - all to ensure a smooth billing process. This is a 6-month temporary position. Duties and Responsibilities: Code office visits and procedures using CPT, ICD-10 codes Audit and review coding (CPT, ICD-10) physician notes in the EHR Manage Coder Correct/ Super Coder Codify Platforms (AAPC) Make coding recommendations; working with providers to ensure accuracy using billing/payer guidelines. Educate providers on coding policies and guidelines, medical necessity criteria, programs correct billing methods and procedure codes by written and verbal communication Correspond or meet with providers to resolve billing practices Audit documentation to ensure it supports complete, accurate and compliant billing with both CMS and payer requirements Assist practice physicians and managers with all coding errors, denials, or issues encountered in the billing process Monitor charge review queues to ensure that all accounts flow through to billing appropriately Submit all charges into billing EHR system AdvancedMD for claims processing Act as liaison between billing department and clinic management/physicians Translate written policy interpretation into CPT, HCPC, ICD-10 codes for input into systems This position is responsible for ensuring compliance with all aspects of applicable regulations, payer billing guidelines. Identify specific billing and reimbursement projects as they arise Conduct research coding on denied claims and take steps toward resolution Correct coding errors in coordination with the billing specialist Reviews insurance plans and carrier information for appropriate coding regulations per payer contracted services Verify insurance information/PCP assignment Ensure/verify the accuracy of patient demographics and insurance information in Electronic Health Record Report trends and denial patterns to the Director of Billing Participate in internal chart audits, billing audits, and other compliance programs Makes recommendations for policies and procedures relating to payer billing guidelines Attending Billing and Interdepartmental meetings. Requirements Competencies: High School Diploma or GED, Billing/Coding Certification Must have experience working in non-profit organization or a community clinic preferred, but not required. Certification in medical billing/coding Minimum 1 years' experience performing medical billing, claims review Minimum 1 years' experience with claims follow-up from physician office, third-party setting Familiarity with medical terminology and the medical record coding process In-depth knowledge/ awareness of all areas related to Payer-specific (Medicare Medi-Cal Medicaid and/or Private) Claims and how they interrelate Knowledge of principles methods and techniques related to compliant healthcare billing/collections - Familiarity with Payer-specific (Medicare Medi-Cal Medicaid -CalAim, Private) Claims management Previous experience with either Electronic Health Record and Practice Management Systems Full understanding of insurance denials, EDI coding rejections and exclusions Previous experience with HCFA 1500 claim forms and electronic billing. Interest/experience working with low-income communities of color Excellent written and verbal communication skills Solid organizational skills including attention to detail and multi-tasking skills. Demonstrates ability to manage time efficiently and multi-task effectively. Clear and effective external and internal, verbal and written, communication skills. Strong critical thinker and problem solver Excellent team-player Ability to work with patients from different backgrounds (culture competency) Ability to communicate clearly and respectfully with co-workers and clients Strong working knowledge of Microsoft Office (Word, Excel, PowerPoint) Ability/willingness to learn Electronic Health Records Insight reporting Roots Community Health Center is proud to be an Equal Employment Opportunity/Affirmative Action Employer and values diversity of culture, thought and lived experiences. We seek talented, qualified individuals regardless of race, color, religion, sex, pregnancy, marital status, age, national origin or ancestry, citizenship, conviction history, uniform service membership/veteran status, physical or mental disability, protected medical conditions, genetic characteristics, sexual orientation, gender identity, gender expression regardless of physical gender, or any other consideration made unlawful by federal, state, or local laws. Roots uses E Verify to validate the eligibility of our new employees to work legally in the United States. Salary Description $31.00-$36.00
$48k-60k yearly est. 60d+ ago
HEALTH INFO SPEC
Covenant Health 4.4
Knoxville, TN jobs
Health Information Specialist, Health Information Administration Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: Compiles and maintains statistics for the department and other areas. Maintains integrity of Master Patient Index. Prepares the monthly birth and death reports for the State of Tennessee. Provides support to staff positions during peak workloads and fills in vacations and holidays. Analyzes/monitors reports. Assists with quality improvement activities and special projects. Maintains microfilm in filing cabinets and storage cage. Assists with training of new employees. Serves as a telephone backup in the department. Serves as a resource person to staff members. Suzie McGuinn: ***************** Responsibilities * Compiles and maintains statistics for the department and other areas. * Serves as a support to clerical and analyst positions within the department. * Assists in the training of new employees. * Prepare the monthly birth and mortality reports for the State Department of Vital Records in a timely manner. * Maintains microfilm. * Assists with quality improvement activities and special projects. * Maintains MPI integrity by performing merges, additions, deletions, and revisions. * Enhances professional growth and development through participation in educational programs, current literature, inservices and workshops. * Attends meetings and serves on committees or teams as required. * Performs other related duties as assigned or requested. * Demonstrates ability to meet or exceed departmental quality and quantity standards. * Adheres to hospital and departmental policies and procedures, including those related to safety and infection control. Qualifications Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED. Minimum Experience: Two (2) years experience in an acute care Medical Record Department preferred. Detail-oriented, good organization skills, ability to work independently, strong interpersonal skills. Licensure Requirement: None
$51k-66k yearly est. Auto-Apply 28d ago
HEALTH INFO SPEC
Covenant Health 4.4
Knoxville, TN jobs
Health Information Specialist, Health Information Administration Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: Compiles and maintains statistics for the department and other areas. Maintains integrity of Master Patient Index. Prepares the monthly birth and death reports for the State of Tennessee. Provides support to staff positions during peak workloads and fills in vacations and holidays. Analyzes/monitors reports. Assists with quality improvement activities and special projects. Maintains microfilm in filing cabinets and storage cage. Assists with training of new employees. Serves as a telephone backup in the department. Serves as a resource person to staff members. Recruiter: Suzie Mcguinn || ***************** Responsibilities * Compiles and maintains statistics for the department and other areas. * Serves as a support to clerical and analyst positions within the department. * Assists in the training of new employees. * Prepare the monthly birth and mortality reports for the State Department of Vital Records in a timely manner. * Maintains microfilm. * Assists with quality improvement activities and special projects. * Maintains MPI integrity by performing merges, additions, deletions, and revisions. * Enhances professional growth and development through participation in educational programs, current literature, inservices and workshops. * Attends meetings and serves on committees or teams as required. * Performs other related duties as assigned or requested. * Demonstrates ability to meet or exceed departmental quality and quantity standards. * Adheres to hospital and departmental policies and procedures, including those related to safety and infection control. Qualifications Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED. Minimum Experience: Two (2) years experience in an acute care Medical Record Department preferred. Detail-oriented, good organization skills, ability to work independently, strong interpersonal skills. Licensure Requirement: None
$51k-66k yearly est. Auto-Apply 60d+ ago
Health Info Spec
Covenant Health 4.4
Knoxville, TN jobs
Health Information Specialist, Health Information Administration Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Summary: Compiles and maintains statistics for the department and other areas. Maintains integrity of Master Patient Index. Prepares the monthly birth and death reports for the State of Tennessee. Provides support to staff positions during peak workloads and fills in vacations and holidays. Analyzes/monitors reports. Assists with quality improvement activities and special projects. Maintains microfilm in filing cabinets and storage cage. Assists with training of new employees. Serves as a telephone backup in the department. Serves as a resource person to staff members. Recruiter: Suzie Mcguinn || ***************** Responsibilities Compiles and maintains statistics for the department and other areas. Serves as a support to clerical and analyst positions within the department. Assists in the training of new employees. Prepare the monthly birth and mortality reports for the State Department of Vital Records in a timely manner. Maintains microfilm. Assists with quality improvement activities and special projects. Maintains MPI integrity by performing merges, additions, deletions, and revisions. Enhances professional growth and development through participation in educational programs, current literature, inservices and workshops. Attends meetings and serves on committees or teams as required. Performs other related duties as assigned or requested. Demonstrates ability to meet or exceed departmental quality and quantity standards. Adheres to hospital and departmental policies and procedures, including those related to safety and infection control. Qualifications Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED. Minimum Experience: Two (2) years experience in an acute care Medical Record Department preferred. Detail-oriented, good organization skills, ability to work independently, strong interpersonal skills. Licensure Requirement: None
$51k-66k yearly est. Auto-Apply 51d ago
Health Info Spec
Covenant Health 4.4
Knoxville, TN jobs
Health Information Specialist, Health Information Administration Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Summary: Compiles and maintains statistics for the department and other areas. Maintains integrity of Master Patient Index. Prepares the monthly birth and death reports for the State of Tennessee. Provides support to staff positions during peak workloads and fills in vacations and holidays. Analyzes/monitors reports. Assists with quality improvement activities and special projects. Maintains microfilm in filing cabinets and storage cage. Assists with training of new employees. Serves as a telephone backup in the department. Serves as a resource person to staff members. Suzie McGuinn: ***************** Responsibilities Compiles and maintains statistics for the department and other areas. Serves as a support to clerical and analyst positions within the department. Assists in the training of new employees. Prepare the monthly birth and mortality reports for the State Department of Vital Records in a timely manner. Maintains microfilm. Assists with quality improvement activities and special projects. Maintains MPI integrity by performing merges, additions, deletions, and revisions. Enhances professional growth and development through participation in educational programs, current literature, inservices and workshops. Attends meetings and serves on committees or teams as required. Performs other related duties as assigned or requested. Demonstrates ability to meet or exceed departmental quality and quantity standards. Adheres to hospital and departmental policies and procedures, including those related to safety and infection control. Qualifications Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED. Minimum Experience: Two (2) years experience in an acute care Medical Record Department preferred. Detail-oriented, good organization skills, ability to work independently, strong interpersonal skills. Licensure Requirement: None
$51k-66k yearly est. Auto-Apply 26d ago
HIM Coder II
Cottage Health System 4.8
Goleta, CA jobs
Santa Barbara Cottage Health seeks a HIM Coder II for their Health Information Management department responsible for coding and abstracting diseases and procedures for accurate administrative and clinic data and optimal hospital reimbursement, utilizing coding guidelines as set forth in Coding Clinic for ICD-9-CM and CPT Assistant for CPT/HCPCS. Major accountabilities include: * Codes diseases and procedures abstracted from the medical record according to ICD-9-CM and CPT classification systems, utilizing only recognized coding guidelines. * Abstracts data for coding utilizing the entire medical record in accordance with approved coding guidelines. QUALIFICATIONS: All job qualifications listed indicate the minimum level necessary to perform this job proficiently. Education: * Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-9-CM and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process. * Preferred: Associates Degree Health Information Management. Certifications, Licenses, Registrations: * Minimum: CSS. * Preferred: CCS and RHIT or RHIA. Years of Related Work Experience: * Minimum: 1 year. * Preferred: 3 years.
$62k-77k yearly est. Auto-Apply 36d ago
HIM Coder II
Cottage Health 4.8
Goleta, CA jobs
Santa Barbara Cottage Health seeks a HIM Coder II for their Health Information Management department responsible for coding and abstracting diseases and procedures for accurate administrative and clinic data and optimal hospital reimbursement, utilizing coding guidelines as set forth in Coding Clinic for ICD-9-CM and CPT Assistant for CPT/HCPCS. Major accountabilities include: Codes diseases and procedures abstracted from the medical record according to ICD-9-CM and CPT classification systems, utilizing only recognized coding guidelines. Abstracts data for coding utilizing the entire medical record in accordance with approved coding guidelines. QUALIFICATIONS: All job qualifications listed indicate the minimum level necessary to perform this job proficiently. Education: Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-9-CM and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process. Preferred: Associates Degree Health Information Management. Certifications, Licenses, Registrations: Minimum: CSS. Preferred: CCS and RHIT or RHIA. Years of Related Work Experience: Minimum: 1 year. Preferred: 3 years.
$62k-77k yearly est. Auto-Apply 14h ago
HIM Coder II
Cottage Health 4.8
Goleta, CA jobs
Santa Barbara Cottage Health seeks a HIM Coder II for their Health Information Management department responsible for coding and abstracting diseases and procedures for accurate administrative and clinic data and optimal hospital reimbursement, utilizing coding guidelines as set forth in Coding Clinic for ICD-9-CM and CPT Assistant for CPT/HCPCS. Major accountabilities include: Codes diseases and procedures abstracted from the medical record according to ICD-9-CM and CPT classification systems, utilizing only recognized coding guidelines. Abstracts data for coding utilizing the entire medical record in accordance with approved coding guidelines. QUALIFICATIONS: All job qualifications listed indicate the minimum level necessary to perform this job proficiently. Education: Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-9-CM and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process. Preferred: Associates Degree Health Information Management. Certifications, Licenses, Registrations: Minimum: CSS. Preferred: CCS and RHIT or RHIA. Years of Related Work Experience: Minimum: 1 year. Preferred: 3 years. Cottage Health is a leading acute care hospital system, located on the central coast of California, widely known for our superior patient care, innovation, medical research and education. Our health system operates primarily in Santa Barbara, Ca, since 1888, and consists of three acute care hospitals, a Rehabilitation Hospital, multiple clinics and a multi-site Urgent Care system. Our mission is to serve the central coast communities with excellence, integrity, and compassion. Every day we touch thousands of lives in many different ways, resolute in our mission to put patients first. We take pride in helping our patients get back to living their lives - in the places they love. Cottage Health is an Equal Opportunity Employer. Cottage Health applicants are considered solely based on their qualifications, without regard to race, color, ethnicity, religion, age, gender, transgender, gender expression and identity, national origin, ancestry, disability, sexual orientation, marital status, military status or any other classification protected by law. This policy applies to all aspects of the relationship between Cottage Health and an applicant or employee. Cottage Health is committed to upholding discrimination-free hiring practices. We strive to cultivate an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work. Any Cottage Health applicants who require assistance or reasonable accommodations during the application process may request the need for accommodation with the Recruiter. If you're already a Cottage Health employee, please apply on this link only. CH Health Information Management, Part Time Regular , 8 hour, Days, Santa Barbara Cottage Health
$62k-77k yearly est. 5d ago
Virtual HIM Outpatient Coding Aud I
Parkland Health & Hospital System 3.9
Dallas, TX jobs
Are you looking for a career that offers both purpose and the opportunity for growth? Parkland Community Health Plan (PCHP) is a proud member of the Parkland Health family. PCHP is a Medicaid Managed Care Organization servicing Texas Medicaid and CHIP in the Dallas Service Area. PCHP works to fulfill of our mission by empowering members to live healthier lives. By joining PCHP, you become part of a team focused on innovation, person-centered care, and fostering stronger communities. As we continue to expand our services, we offer opportunities for you to grow in your career while making a meaningful impact. Join us and work alongside a talented team where healthcare is more than just a job-it's a passion to serve and improve lives every day. PRIMARY PURPOSE Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. MINIMUM SPECIFICATIONS Education: * Must be a graduate of a Health Information Management program or must have successfully completed an approved Coding educational program. Experience * Must have six (6) years of proven coding experience in an acute care setting. Equivalent Education and/or Experience * May have an equivalent combination of education and experience in lieu of specified requirements. Certification/Registration/Licensure * Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to provide proof of renewal. Although an additional seven (7) calendar days is allowed to provide proof of renewal, there cannot be a lapse in the certification's "active" status. * Must possess one of the below certifications: * Registered Health Information Administrator (RHIA) * Registered Health Information Technician (RHIT) * Certified Coding Specialist (CCS), * Certified Professional Coder (CPC) * Certified Coding Specialist - Physician (CCS-P) * Certified Inpatient Coder (CIC) * Certified Outpatient Coder (COC) * Certified Professional Medical Auditor (CPMA) Required Tests for Placement * Must score a minimum of 85% on a pre-employment coding test. Skills or Special Abilities * Must be able to demonstrate time management, organizational, oral and written communication skills. * Must be proficient and demonstrate and advanced knowledge in ICD-9-CM and CPT/HCPCS coding and abstracting and have an advanced clinical knowledge of medical terminology, disease process and pharmacology. * Must be able to demonstrate knowledge of reimbursement (Medicare and Medicaid) principles and methodologies (MS-DRG and APC). * Must have a working knowledge of the compliance guidelines related to coding and billing. - Must have strong skills in diplomacy, professionalism and trustworthiness. * Must be able to demonstrate excellent computer skills, including word processing, spreadsheet and database management software proficiency. Responsibilities 1. Conducts quality reviews on all coders using the "official coding guidelines" as published in AHA Coding Clinic and AMA CPT Assistant, and hospital policy, including specific payer guidelines, rules, regulations in analyzing questionable documentation to ensure the accuracy and completeness of clinical and financial information reported for billing of hospital services. Provides feedback to the coders on findings as needed. Provides reports of findings to the Coding Compliance Manager. The Outpatient area utilizes the CMS regulatory coding and billing guidelines, the National Correct Coding Initiative, the Local and National Coverage Determinations to resolve billing edits. 2. Analyzes medical record documentation to assure that coding and abstracting of data is in compliance with the official coding guidelines as published in the American Hospital Association s Coding Clinic for ICD-9-CM and the American Medical Associations CPT Assistant. 3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area. Provides input as requested to assist in the development of effective internal controls that promote adherence to applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans. 4. Stays abreast of the latest developments, advancements, and trends in medical records coding by attending educational programs, reading professional journals, actively participating in professional organizations, and maintaining certification. Integrates knowledge gained into current work practices. 5. Assists in ensuring that abstracted coded data and other elements are correct and appropriate. Assists in ensuring that data being submitted to state/federal and other regulatory agencies is correct and appropriate. 6. Maintains a positive working relationship with physicians, nurses, medical staff and hospital employees to ensure that all work-related encounters are productive. 7. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals for the department and Parkland. 8. This position is 100% Virtual. Virtual employees must also comply with all Parkland policies and procedures governing the use of Parkland information resources. Virtual employees must maintain all equipment lent by Parkland for performing the agreed upon job duties in good working condition. All employment responsibilities and conditions in applicable Parkland policies and procedures apply to employees while working virtually. Parkland Community Health Plan (PCHP) prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. Nearest Major Market: Dallas Nearest Secondary Market: Fort Worth Job Segment: Medical Coding, Medicaid, Medicare, Public Health, Healthcare
$47k-60k yearly est. 29d ago
Health Information Management (HIM) Coder - Outpatient - PER DIEM
Rome Health 4.4
Rome, NY jobs
Rome Health is looking for a per diem OP coder to join the Health Information Management team. This team member will assist with backlogs and coverage during staff PTO. •Current coding certification required •Three years of experience coding Observation and/or Ambulatory Surgery preferred •Experience with Clintegrity, Paragon, One Content helpful •Fully remote after training Extensive knowledge of medical terminology. Experience in researching and applying coding rules and guidelines required. Must have experience with data entry of codes into a database. Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems. Excellent oral and written communication skills. Must have a positive, respectful attitude. About Rome Health Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
$40k-52k yearly est. 60d+ ago
Health Information Management -HIM - Coder - Inpatient -REMOTE
Rome Health 4.4
Rome, NY jobs
Health Information Management - HIM - Coder - Inpatient The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations. Understands importance coding plays in the revenue cycle process Meets or exceeds coding productivity and quality standards Assists with DRG appeals as necessary Assists Coding Manager with identifying problems or trends that need immediate attention Adheres to all department and hospital policies and procedures High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required. KNOWLEDGE AND SKILLS REQUIRED: Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties. About Rome Health Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
$40k-52k yearly est. 60d+ ago
Health Information Management - HIM - Coder - Inpatient - REMOTE
Rome Health 4.4
Rome, NY jobs
Job Description Health Information Management - HIM - Coder - Inpatient The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations. •Understands importance coding plays in the revenue cycle process •Meets or exceeds coding productivity and quality standards •Assists with DRG appeals as necessary •Assists Coding Manager with identifying problems or trends that need immediate attention •Adheres to all department and hospital policies and procedures High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required. KNOWLEDGE AND SKILLS REQUIRED: Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties. About Rome Health Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
$40k-52k yearly est. 2d ago