Medical Coder jobs at Mercy Health

- 29 jobs

Outpatient Coding Specialist - Work at Home - Any State
Mercy Health 4.4
Medical coder job at Mercy Health
Thank you for considering a career at Mercy Health! Scheduled Weekly Hours: 40 Work Shift: Days/Afternoons (United States of America) Advanced outpatient coding position that reviews medical record documentation and accurately assign ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA,) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications. Utilizing Coding Applications in accordance with established workflow. . Follows Mercy Policies and Procedures and maintains required quality and productivity standards. ESSENTIAL FUNCTIONS Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types (Ancillary, ED Charge/Code, Same Day Surgery, and Observation. . The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management, (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third party software systems such as LYNX. ·Correctly abstract required data per facility specifications. ·Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines. Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and premise as a team, ensure timely, compliant processing of outpatient claims in the billing system. Responsible to maintain established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards. Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS,) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through. Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC,) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy Follows all established Mercy Health policies and procedures to include abiding by paid time off, (PTO) requirements. Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth. Training/Mentoring - SMART Responsibilities where applicable Required Minimum Education: Vocational/Technical Degree, Specialty/Major: HIM / Coding Certification Preferred Education: 2 year/Associate's Degree, Specialty/Major: HIM / Coding Certification LICENSURE/CERTIFICATIONS (must be non-expired/active unless otherwise stated): Required: If RHIA or RHIT or CCA upon hire without COC or CCS, will be required to acquire COC or CCS and CRCR within 1 year of hire Preferred: RHIA or RHIT or CCS or COC or CCA or CPC MINIMUM QUALIFICATIONS Minimum Years and Type of Experience: Completion of Coding Curriculum with one year of previous coding experience. Other Knowledge, Skills and Abilities Required: Satisfactory completion of Medical Terminology and Anatomy and Physiology. Completion of ICD-10 training. Previous use of Coding Software Tools. Knowledge of medical record content to include electronic medical records, (EMRs.) Ability to function independently, with minimal supervision, as well as part of a team. Ability to function under continual deadlines. Ability to maintain accuracy during frequent interruptions. Proficiency in keyboarding skills and working knowledge of computers. Excellent communication skills. Other Knowledge, Skills and Abilities Preferred: Previous coding experience in an acute care setting and previous use of coding software tools. Previous use of CAC. Mercy Health is an equal opportunity employer. As a Mercy Health associate, you're part of a Misson that matters. We support your well-being - personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. What we offer • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) • Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts • Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders • Tuition assistance, professional development and continuing education support Benefits may vary based on the market and employment status. Department: SS Revenue Cycle - Legacy MH Acute It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, a ll applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health- Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email *********************. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at *********************.
$34k-50k yearly est. Auto-Apply 3d ago
Manager, Infection Prevention- Mercy Health Youngstown and Lorain
Mercy Health 4.4
Medical coder job at Mercy Health
Thank you for considering a career at Mercy Health! Scheduled Weekly Hours: 40 Work Shift: Days (United States of America) Responsible for implementing system infection prevention strategies, policies and practices at the market/site level. Leads market integration and standardization. Works closely with and collaborates with the System Director, Infection Prevention. Serves as subject matter expert for infection prevention. Leads, coaches and mentors the site and/or market-based infection prevention team(s). Essential Job Functions Manages the operation of the Infection Prevention and Control Program to ensure patient and personnel safety, in alignment with system goals, and compliance with State and Federal regulatory requirements. Responsible for analyzing, coordinating, and evaluating all infection prevention and control practices within all hospital departments and clinics Provides leadership and management of key infection and control initiatives to reduce preventable infections applying epidemiologic principles and statistical methods. Provides oversight for the development and review of the annual infection control plans and surveillance indicators. Participates and directs, where necessary, emergency management planning and bioterrorism readiness program. Participates in and contributes to the system wide infection prevention initiatives through implementation of improvement projects and policy/procedure development. Lead and coordinate facility risk assessments, healthcare associated infection reviews, surveillance plans, and construction infection control risk assessments. Leads and participates in the day to day infection prevention activities including surveillance, rounding, preparing and dissemination of reports and communication. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation. Education Qualifications - Required Minimum Education: Bachelor's Degree Nursing or healthcare related field Preferred Education: Masters Degree Nursing or other health related field Completion of advanced education in Infection Prevention- Preferred Licensing/ Certification - Certification in Infection Control (CIC), awarded by the Certification Board of Infection Control and Epidemiology, Inc. (CBIC), Required within 3 years of start date Minimum Qualifications Minimum Years and Type of Experience 5-7 years of demonstrated progressive leadership Other Knowledge, Skills and Abilities Required Demonstrated ability/experience to lead and facilitate multi-disciplinary teams Other Knowledge, Skills and Abilities Preferred Knowledge of improvement science. Mercy Health is an equal opportunity employer. As a Mercy Health associate, you're part of a Misson that matters. We support your well-being - personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. What we offer • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) • Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts • Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders • Tuition assistance, professional development and continuing education support Benefits may vary based on the market and employment status. Department: Infection Prevention - Quality It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, a ll applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health- Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email *********************. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at *********************.
$55k-100k yearly est. Auto-Apply 3d ago
Coder II - Surgical (Remote)
Cedars-Sinai 4.8
Los Angeles, CA jobs
Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. **What will you be doing in this role?** Under general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC. Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II include: + Performs accurate and timely coding (CPT, ICD-10, HCPCS, modifiers). + Maintains familiarity with issues like coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. referral, surgeries, etc. + Understands and implements coding guidelines for multi-specialty surgical practices and/or complex surgical coding. + Attends seminars and workshops, as applicable, for updates on new coding rules and regulations. + Elevates issues, as appropriate, to the Coding Supervisor and Manager. + Meets productivity and quality standards as designated by Coding Supervisor and Manager. + Understands coding trends to include NCD, LCD, and CMS guidelines. + Identifies trends and issues with overall division and individual physician coding practices and presents solutions. + Maintains confidentiality of patient care and business matters. + Follows policies and procedures pertinent to the coding and compliance departments. **Qualifications** **Requrements:** Certified Procedural Coder (CPC) required. Certified Surgical Specialty Credentials (CGSC or others) preferred. High school diploma or GED required. **Experience we are Seeking:** Minimum of 3 years of surgical coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Orthopedics, Cardiothoracic Surgery, Neurosurgery, General Surgery, Obstetrics/Gynecology, Gastroenterology) Familiarity with ICD-10-CM, CPT-4 coding and payment methodologies. Working knowledge of all California and National reporting requirements. **Why Work Here?** Beyond outstanding employee benefits including health and vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation. **Req ID** : 8091 **Working Title** : Coder II - Surgical (Remote) **Department** : CSRC - Coding Profee **Business Entity** : Cedars-Sinai Medical Center **Job Category** : Patient Financial Services **Job Specialty** : Medical Coding **Overtime Status** : NONEXEMPT **Primary Shift** : Day **Shift Duration** : 8 hour **Base Pay** : $31.98 - $49.57 Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.
$32-49.6 hourly 44d ago
E/M Multi-Specialty Coder - Coder II (Remote)
Cedars-Sinai 4.8
Los Angeles, CA jobs
Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company's Workplace of the Year. Discover why U.S. News & World Report has named us one of America's Best Hospitals! **What will you be doing in this role?** In this remote role, under the general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC. Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II include: + Performs accurate and timely coding (CPT, ICD-9, ICD-10, HCPCS, modifiers). + Maintains familiarity with issues like HCFA coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. referral, surgeries, etc. + Understands and implements coding guidelines for multi-specialty surgical practices and/or complex surgical coding. + Attends seminars and workshops, as applicable, for updates on new coding rules and regulations. + Elevates issues, as appropriate, to the Coding Supervisor and Manager. + Meets productivity and quality standards as designated by Coding Manager + Understands coding trends to include NCD, LCD, and CMS guidelines. + Identifies trends and issues with overall division and individual physician coding practices and presents solutions. + Maintains confidentiality of patient care and business matters. + Follows policies and procedures pertinent to the coding and compliance departments. **Qualifications** **Requirements:** Certified Procedural Coder (CPC) required. Certified Evaluation and Management Coder (CEMC) a plus. High school diploma or GED required. Completion of courses in ICD-10-CM and CPT-4 coding from an accredited coding program preferred. **Experience we are Seeking:** Minimum of 3 years of coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Cardiothoracic Surgery, Neurosurgery, General Surgery, Orthopedics, Obstetrics/Gynecology) preferred. Familiarity with ICD-10-CM, CPT-4 coding and payment methodologies. Working knowledge of all California and National reporting requirements. **Why work here?** Beyond outstanding employee benefits including health and vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation. **Req ID** : 12901 **Working Title** : E/M Multi-Specialty Coder - Coder II (Remote) **Department** : CSRC - Coding Profee **Business Entity** : Cedars-Sinai Medical Center **Job Category** : Patient Financial Services **Job Specialty** : Medical Coding **Overtime Status** : NONEXEMPT **Primary Shift** : Day **Shift Duration** : 8 hour **Base Pay** : $31.98 - $49.57 Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.
$32-49.6 hourly 60d+ ago
Coder II - Surgical (Remote)
Cedars-Sinai 4.8
Los Angeles, CA jobs
Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What will you be doing in this role? Under general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC. Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II include: Performs accurate and timely coding (CPT, ICD-10, HCPCS, modifiers). Maintains familiarity with issues like coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. referral, surgeries, etc. Understands and implements coding guidelines for multi-specialty surgical practices and/or complex surgical coding. Attends seminars and workshops, as applicable, for updates on new coding rules and regulations. Elevates issues, as appropriate, to the Coding Supervisor and Manager. Meets productivity and quality standards as designated by Coding Supervisor and Manager. Understands coding trends to include NCD, LCD, and CMS guidelines. Identifies trends and issues with overall division and individual physician coding practices and presents solutions. Maintains confidentiality of patient care and business matters. Follows policies and procedures pertinent to the coding and compliance departments. Requrements: Certified Procedural Coder (CPC) required. Certified Surgical Specialty Credentials (CGSC or others) preferred. High school diploma or GED required. Experience we are Seeking: Minimum of 3 years of surgical coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Orthopedics, Cardiothoracic Surgery, Neurosurgery, General Surgery, Obstetrics/Gynecology, Gastroenterology) Familiarity with ICD-10-CM, CPT-4 coding and payment methodologies. Working knowledge of all California and National reporting requirements. Why Work Here? Beyond outstanding employee benefits including health and vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
$67k-83k yearly est. Auto-Apply 47d ago
E/M Multi-Specialty Coder - Coder II (Remote)
Cedars-Sinai 4.8
Los Angeles, CA jobs
Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company's Workplace of the Year. Discover why U.S. News & World Report has named us one of America's Best Hospitals! What will you be doing in this role? In this remote role, under the general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC. Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II include: Performs accurate and timely coding (CPT, ICD-9, ICD-10, HCPCS, modifiers). Maintains familiarity with issues like HCFA coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. referral, surgeries, etc. Understands and implements coding guidelines for multi-specialty surgical practices and/or complex surgical coding. Attends seminars and workshops, as applicable, for updates on new coding rules and regulations. Elevates issues, as appropriate, to the Coding Supervisor and Manager. Meets productivity and quality standards as designated by Coding Manager Understands coding trends to include NCD, LCD, and CMS guidelines. Identifies trends and issues with overall division and individual physician coding practices and presents solutions. Maintains confidentiality of patient care and business matters. Follows policies and procedures pertinent to the coding and compliance departments. Requirements: Certified Procedural Coder (CPC) required. Certified Evaluation and Management Coder (CEMC) a plus. High school diploma or GED required. Completion of courses in ICD-10-CM and CPT-4 coding from an accredited coding program preferred. Experience we are Seeking: Minimum of 3 years of coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Cardiothoracic Surgery, Neurosurgery, General Surgery, Orthopedics, Obstetrics/Gynecology) preferred. Familiarity with ICD-10-CM, CPT-4 coding and payment methodologies. Working knowledge of all California and National reporting requirements. Why work here? Beyond outstanding employee benefits including health and vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
$67k-83k yearly est. Auto-Apply 60d+ ago
Claims Edit Coder
Cedars-Sinai 4.8
Remote
Bring your whole self to exceptional care. Cedars-Sinai was tied for #1 in California in U.S. News & World Report's "Best Hospitals 2024-25" rankings, and it's all thanks to our team of 14,000+ remarkable employees! What you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure code for claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits that necessitate research and resolution, and validating key data elements like the billing physician and date of service. You are expected to abstract coded data accurately and promptly into the applicable system using relevant applications such as EPIC (CS-Link), EPIC HB and PB modules, Solventum 360Encompass, Solventum Standalone Encoder, and Select Coder. This role demands proficiency in these systems to ensure the integrity and efficiency of coding operations. Duties include: Review medical documentation and health information within various electronic medical or health systems. Assign applicable codes such as clinical modification (ICD-10-CM), current procedural terminology (CPT), evaluation and management (E&M), and healthcare common procedure coding system (HCPCS) while adhering to productivity and quality standards for the area(s) of assignment or specialty (Facility or Professional). Focus on specialties including, but not limited to: Professional Multispecialty E&M, Facility Emergency Room (non-Single Path), and Outpatient Visits (Facility or Professional). Resolve complex edits and alerts with consistent accuracy using current guidelines for the area(s) of assignment or specialty. Handle edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits. Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty. Expanding skills in procedural coding such as CPT or PCS. Requirements: Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required upon hire. High school diploma or GED required. Minimum of 2 years of experience working doing code assignment in a healthcare setting. Ability to produce quality work product within the established standards per hour. Why work here? Beyond outstanding employee benefits including health, paid vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
$58k-72k yearly est. Auto-Apply 25d ago
Facility Inpatient Coder (Remote)
Cedars-Sinai 4.8
Remote
Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. Join us, and discover why U.S. News & World Report has named us one of America's Best Hospitals! What you will be doing in this role: Working under the general direction of a coding supervisor, the Facility Inpatient Coder is responsible for the assignment of ICD-10-CM and ICD-10-PCS codes by reviewing all appropriate documentation in accordance with standard coding guidelines. Correctly identifies the principal diagnosis, comorbidities/complications, present on admission indicators, and determines sequencing of codes to calculate the most appropriate DRG representing the patient stay. Knowledge of both Medicare Severity Diagnosis Related Groups (MS-DRG) and All Patient Refined Diagnosis Related Groups (APR-DRG) is required. This position will require knowledge of appropriate capture of codes for statistical purposes such as Social Determinants of Health (SDOH), Hierarchical Conditions (HCC), and severity impacting conditions. Abstracts data elements to satisfy statistical requests by the health system, medical staff, and enters all coded/abstracted information into the assigned system. Identifies opportunities for documentation improvement and seeks clarity by the physicians. Communicates collaboratively with the Clinical Documentation Integrity (CDI) team to align both clinical and coding approaches to ensure a complete coding profile. Ability to reference anatomy, physiology, and clinical practice to support code assignment and contribute to CDI discussions. The position requires abstraction of coded data in a timely and accurate manner into the applicable system using the applications appropriate to the work assignment. This may include: EPIC (CSLink), EPIC HB, Solventum 360Encompass, Solventum Standalone Encoder, Select Coder, etc. Translates medical records/health information including diagnoses, procedures and treatment and assigns standardized codes (International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), International Classification of Diseases, Tenth Revision, and Procedure Coding System (ICD-10-PCS), for patients receiving services within the Cedars Sinai Health System and its affiliates. Primary duties include: Reviewing medical documentation/health information within various electronic medical/health system(s) and assigning applicable codes (ICD-10-CM, ICD-10-PCS) within productivity and quality standard for area(s) of assignment/specialty (Facility). Abstracting all required data elements for reporting and statistical capture. Resolving complex inpatient edits/alerts with consistent accuracy using current guidelines within area(s) of assignment/specialty. Requirements: High school diploma or GED required. A minimum of 3 years' work experience doing code assignment in a healthcare setting performing similar coding duties required. Why work here? Beyond outstanding employee benefits including health and dental insurance, paid vacation, and a 403(b), we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
$58k-72k yearly est. Auto-Apply 3d ago
Coder II (Remote)
Cedars-Sinai Medical Center 4.8
Remote
Bring your whole self to exceptional care. Cedars-Sinai was tied for #1 in California in U.S. News & World Report's "Best Hospitals 2024-25" rankings, and it's all thanks to our team of 14,000+ remarkable employees! What you will be doing in this role: Under general direction of the section Coding Supervisor, performs assignment of codes as applicable to specific area of assignment. This may include ICD-CM, CPT including Evaluation and Management, HCPCS, and modifiers. Coder II will maintain and apply knowledge of both internal and external regulatory entities related to coding guidelines, definition of type of visit, medical terminology, anatomy/physiology/pathology basis of disease, and understanding of documented treatment/procedures performed. Correctly assigns applicable modifiers in accordance with assigned area of responsibility. Abstracts all collected data as applicable to assignment. Maintains a solid understanding of all California and National coding and reporting requirements. Duties include: Codes all records within the established departmental quality standards. Follows internal departmental guidance related to workflow. Maintains "nonproductive time" logs and turns them as required by each section. Maintains required CEUs per policy and credentials in a timely manner. May be asked to help train new team members or serve as a buddy/mentor to teammates Meets established departmental productivity and accuracy standards Consistently and accurately abstracts additional data elements (OSHPD elements, Special studies, etc.) as required. Communicates to Coding Supervisor any concerns regarding coding, documentation, section issues and department issues. Maintains knowledge of coding updates through provided or self- learning to ensure compliance with all changes. Qualifications Requirements: Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required. High school diploma or GED required. Associate degree in Health Information Science preferred. Completion of courses in ICD-10-CM and CPT-4 coding from an accredited coding program preferred Minimum of 3 years of experience with outpatient/ambulatory care or inpatient/acute care coding required. Experience with Emergency room and surgical coding observation a plus. Experience we are Seeking: Familiarity with ICD-10-CM, CPT-4 coding and APC payment methodologies preferred. Working knowledge of all California and National reporting requirements. Why work here? Beyond outstanding employee benefits including health and vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
$58k-72k yearly est. Auto-Apply 60d+ ago
Outpatient Hospital Reimbursement & Coding Specialist III, Remote
Erlanger Health 4.5
Chattanooga, TN jobs
Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY REMOTE Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators (inpatient only) on inpatient or outpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Inpatient Coding * Must code all types of adult and pediatric Inpatient cases including long length of stays, mortality, trauma, L&D, NICU, and normal newborns. Outpatient Coding * Must code all types of outpatient cases includes, ED, outpatient, OBS, Same Day Surgery. Detailed responsibilities: 1. Reviews inpatient or outpatient medical records to assign and sequence all appropriate diagnosis and procedures codes utilizing encoder software and following by proficiently translating diagnostic statements, procedure descriptions, physician orders, and other pertinent documentation. Reviews Medicare Severity Diagnosis Related Groups (MSDRGs) and All Patient Refined Diagnosis Related Groups (APRDRGs) on inpatient cases or Ambulatory Payment Classification (APCs) on outpatient cases for appropriate code assignment. 2. Reviews and validates accuracy of Admission-Discharge-Transfer (ADT) data fields; abstracts admission type, point of origin, discharge disposition, physicians, procedure dates and on inpatient cases present on admission (POA) indicators. 3. Reviews appropriate coding work queues daily to address coding edits and needed corrections and follows procedure to notify billing as needed. Reviews accounts and performs needed correction for internal audits and external denials. 4. When documentation or valid order is incomplete, vague, or ambiguous, it is the responsibility of coder to work in conjunction with Leadership to utilize the appropriate physician clarification process to obtain additional information that provides a codeable diagnosis, procedure and/or physician order. 5. Outpatient coders are responsible for following charge verification processes and routing accounts based on missing, incomplete, or inaccurate charging. Other responsibilities include: * Adherence to Health Information Management (HIM) Coding policies. * Interprets and applies American Hospital Association (AHA) Official Coding Guidelines to articulate and support appropriate principal, secondary diagnoses and procedures. OP coding validates reason for visit and IP validates admit diagnosis. * Adherence to Det Norske Veritas (DNV) and other third-party documentation guidelines in an effort to continually improve coding quality and accuracy. * Responsibility for maintaining coding certification and knowledge referencing diagnosis and procedural coding classification system coding guidelines and regulatory changes. * Contacts the appropriate department or physician for assistance in obtaining physician clarification of Diagnoses and procedures. * Participates in performance improvement initiatives as assigned. This position must consistently meet or exceed productivity and quality standards as defined by department Leadership. The coder must have: 1. Knowledge of Anatomy and Physiology, Disease Pathology, and Medical Terminology. 2. Knowledge of coding conventions and use of coding nomenclature consistent with CMS Official Guidelines for Coding and Reporting ICD-10-CM coding. 3. Accurate translation of written diagnostic descriptions to appropriately and accurately assign ICD-10-CM diagnostic codes to obtain optimal reimbursement from all payer types, including Medicare/Medicaid, and private insurance payers. 4. Accurate translation of written procedure descriptions to accurately assign ICD 10 PCS procedure codes for inpatient and CPT/HCPCs codes for outpatient accounts. 5. Ability to navigate the Electronic Medical Record to identify appropriate documentation for coding/billing in support of submitted department charges. 6. Knowledge of clinical content standards. Education: Required: * Validation of coding certification, i.e., specialty focus such as ICD-10-CM coding, ICD-10-PCS, CPT coding, and billing practices from an accredited program. Preferred: * BS or AS degree in Health Information Management Administration or Health Information Technician from an accredited program. Experience: Required: * Must demonstrate knowledge of coding to support this position. * Ability to follow standard practices in coding and reimbursement. * Demonstrate the knowledge of optimization of coding for reimbursement. * Computer literate in a windows environment, also basic word processing skills, knowledge of MS Office and a basic graphics package. * Possess excellent communication skills both written and oral. * Demonstration of sound judgment and organizational ability. * Ability and knowledge to maintain a quality and quantity standard in coding. * Must have 4 years of coding experience in an acute care hospital. Preferred: * Level 1 Academic medical center experience Position Requirement(s): License/Certification/Registration Required: * RHIT, RHIA, CCS, CPC, or CPC-H Preferred: * N/A Department Position Summary: The employee must be able to demonstrate the knowledge and skills necessary to optimally code inpatient or outpatient encounters (based on team assigned). The individual must demonstrate knowledge of the various payment schemes for inpatient encounters or outpatient encounters. The individual must demonstrate the ability to be flexible as to the type of encounter to be coded. The associate must demonstrate the ability to work in a self-directed team by taking and giving direction and sharing in the responsibility of the team. The associate must display the ability to be self-motivated, be able to evaluate the scope of each day's work, and display time management skills to accomplish assigned work. Must be able to work effectively in a remote work capacity. The associate must provide management with annual/biannual proof of certification and complete annual/biannual required continuing education. The associate will perform any other tasks as assigned. '252736
$51k-64k yearly est. 60d+ ago
Inpatient Coder - Work at Home - Any State
Bon Secours Mercy Health 4.8
Cincinnati, OH jobs
At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, CPT IV codes, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes 3M 360 in accordance with established workflow. Follows Ensemble policies and procedures and maintains required quality and productivity standards. **Essential Job Functions** + Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG.) The Inpatient Coding Specialist is responsible for verification of the patient's discharge disposition and to ensure the appropriate present on admission, (POA) indicators are assigned to each code. The assigned codes must support the reason for the visit that is documented by the provider in order to support the care provided. + Correctly abstract required data per facility specifications. + Responsible to assist with writing appeals for Diagnosis Related Group, (DRG) denials in order to support the assigned Diagnosis Related Group, (DRG) and to address the clinical documentation utilized in the decision making process to support the validity of the assigned codes. + Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis, and as a team, ensure timely, compliant processing of inpatient accounts through the billing system. + Collaborates with Clinical Documentation Specialists, (CDEs,) and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG,) may be assigned. + Responsible to ensure accuracy and maintain established quality, productivity standards, and key performance indicators established for 3M 360 CAC for CRS and Direct Code. + Remain abreast of current Centers for Medicare and Medicaid Services, (CMS) requirements as well as Correct Coding Initiative, (CCI) edits, Hospital Acquired Conditions, (HAC's) and when applicable, National Coverage Determinations, (NCDs) and Local Coverage Determinations, (LCDs,) including the addition of appropriate modifiers to ensure a clean claim the first time through. + Maintains competency and accuracy while utlizing tools of the trade, such as the 3M encoder, Computer Assisted Coding, (CAC,) Clinical Documentation Improvement System, (CDIS,) and abstracting systems, and all reference materials. Reports inaccuracies found in software applications to HIM Coding Manager/Supervisor, reports any potential unethical and/or fradulent activity per compliance policy. + This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation **Required Licensure:** RHIA, RHIT, CCS, CIC, or CCA As a Bon Secours Mercy Health associate, you're part of a Mission that matters. We support your well-being-personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. **What we offer** + Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) + Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts + Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders + Tuition assistance, professional development and continuing education support _Benefits may vary based on the market and employment status._ All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon secours Mercy Health - Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email ********************* . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at *********************
$40k-52k yearly est. 2d ago
Outpatient Coding Specialist - Work at Home - Any State
Bon Secours Mercy Health 4.8
Cincinnati, OH jobs
At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Advanced outpatient coding position that reviews medical record documentation and accurately assign ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA,) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications. Utilizing Coding Applications in accordance with established workflow. . Follows Mercy Policies and Procedures and maintains required quality and productivity standards. **ESSENTIAL FUNCTIONS** + Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types (Ancillary, ED Charge/Code, Same Day Surgery, and Observation. . The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management, (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third party software systems such as LYNX. + ·Correctly abstract required data per facility specifications. + ·Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines. + Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and premise as a team, ensure timely, compliant processing of outpatient claims in the billing system. + Responsible to maintain established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards. + Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS,) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through. + Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC,) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy + Follows all established Mercy Health policies and procedures to include abiding by paid time off, (PTO) requirements. + Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth. + Training/Mentoring - SMART Responsibilities where applicable **Required Minimum Education:** + Vocational/Technical Degree, Specialty/Major: HIM / Coding Certification + Preferred Education: 2 year/Associate's Degree, Specialty/Major: HIM / Coding Certification + LICENSURE/CERTIFICATIONS (must be non-expired/active unless otherwise stated): + Required: If RHIA or RHIT or CCA upon hire without COC or CCS, will be required to acquire COC or CCS and CRCR within 1 year of hire + Preferred: RHIA or RHIT or CCS or COC or CCA or CPC **MINIMUM QUALIFICATIONS** + Minimum Years and Type of Experience: Completion of Coding Curriculum with one year of previous coding experience. + Other Knowledge, Skills and Abilities Required: Satisfactory completion of Medical Terminology and Anatomy and Physiology. Completion of ICD-10 training. Previous use of Coding Software Tools. + Knowledge of medical record content to include electronic medical records, (EMRs.) Ability to function independently, with minimal supervision, as well as part of a team. + Ability to function under continual deadlines. Ability to maintain accuracy during frequent interruptions. + Proficiency in keyboarding skills and working knowledge of computers. Excellent communication skills. + Other Knowledge, Skills and Abilities Preferred: Previous coding experience in an acute care setting and previous use of coding software tools. Previous use of CAC. As a Bon Secours Mercy Health associate, you're part of a Mission that matters. We support your well-being-personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. **What we offer** + Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) + Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts + Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders + Tuition assistance, professional development and continuing education support _Benefits may vary based on the market and employment status._ All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon secours Mercy Health - Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email ********************* . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at *********************
$40k-52k yearly est. 3d ago
Hospital Reimbursement & Coding Specialist III, Remote
Erlanger 4.5
Tennessee jobs
Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators (inpatient only) on inpatient or outpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Inpatient Coding - Must code all types of adult and pediatric Inpatient cases including long length of stays, mortality, trauma, L&D, NICU, and normal newborns. Outpatient Coding - Must code all types of outpatient cases includes, ED, outpatient, OBS, Same Day Surgery. Detailed responsibilities: 1. Reviews inpatient or outpatient medical records to assign and sequence all appropriate diagnosis and procedures codes utilizing encoder software and following by proficiently translating diagnostic statements, procedure descriptions, physician orders, and other pertinent documentation. Reviews Medicare Severity Diagnosis Related Groups (MSDRGs) and All Patient Refined Diagnosis Related Groups (APRDRGs) on inpatient cases or Ambulatory Payment Classification (APCs) on outpatient cases for appropriate code assignment. 2. Reviews and validates accuracy of Admission-Discharge-Transfer (ADT) data fields; abstracts admission type, point of origin, discharge disposition, physicians, procedure dates and on inpatient cases present on admission (POA) indicators. 3. Reviews appropriate coding work queues daily to address coding edits and needed corrections and follows procedure to notify billing as needed. Reviews accounts and performs needed correction for internal audits and external denials. 4. When documentation or valid order is incomplete, vague, or ambiguous, it is the responsibility of coder to work in conjunction with Leadership to utilize the appropriate physician clarification process to obtain additional information that provides a codeable diagnosis, procedure and/or physician order. 5. Outpatient coders are responsible for following charge verification processes and routing accounts based on missing, incomplete, or inaccurate charging. Other responsibilities include: - Adherence to Health Information Management (HIM) Coding policies. - Interprets and applies American Hospital Association (AHA) Official Coding Guidelines to articulate and support appropriate principal, secondary diagnoses and procedures. OP coding validates reason for visit and IP validates admit diagnosis. - Adherence to Det Norske Veritas (DNV) and other third-party documentation guidelines in an effort to continually improve coding quality and accuracy. - Responsibility for maintaining coding certification and knowledge referencing diagnosis and procedural coding classification system coding guidelines and regulatory changes. - Contacts the appropriate department or physician for assistance in obtaining physician clarification of Diagnoses and procedures. - Participates in performance improvement initiatives as assigned. This position must consistently meet or exceed productivity and quality standards as defined by department Leadership. The coder must have: 1. Knowledge of Anatomy and Physiology, Disease Pathology, and Medical Terminology. 2. Knowledge of coding conventions and use of coding nomenclature consistent with CMS Official Guidelines for Coding and Reporting ICD-10-CM coding. 3. Accurate translation of written diagnostic descriptions to appropriately and accurately assign ICD-10-CM diagnostic codes to obtain optimal reimbursement from all payer types, including Medicare/Medicaid, and private insurance payers. 4. Accurate translation of written procedure descriptions to accurately assign ICD 10 PCS procedure codes for inpatient and CPT/HCPCs codes for outpatient accounts. 5. Ability to navigate the Electronic Medical Record to identify appropriate documentation for coding/billing in support of submitted department charges. 6. Knowledge of clinical content standards. Education: Required: - Validation of coding certification, i.e., specialty focus such as ICD-10-CM coding, ICD-10-PCS, CPT coding, and billing practices from an accredited program. Preferred: - BS or AS degree in Health Information Management Administration or Health Information Technician from an accredited program. Experience: Required: - Must demonstrate knowledge of coding to support this position. - Ability to follow standard practices in coding and reimbursement. - Demonstrate the knowledge of optimization of coding for reimbursement. - Computer literate in a windows environment, also basic word processing skills, knowledge of MS Office and a basic graphics package. - Possess excellent communication skills both written and oral. - Demonstration of sound judgment and organizational ability. - Ability and knowledge to maintain a quality and quantity standard in coding. - Must have 4 years of coding experience in an acute care hospital. Preferred\: - Level 1 Academic medical center experience Position Requirement(s)\: License/Certification/Registration Required: - RHIT, RHIA, CCS, CPC, or CPC-H Preferred: - N/A Department Position Summary: The employee must be able to demonstrate the knowledge and skills necessary to optimally code inpatient or outpatient encounters (based on team assigned). The individual must demonstrate knowledge of the various payment schemes for inpatient encounters or outpatient encounters. The individual must demonstrate the ability to be flexible as to the type of encounter to be coded. The associate must demonstrate the ability to work in a self-directed team by taking and giving direction and sharing in the responsibility of the team. The associate must display the ability to be self-motivated, be able to evaluate the scope of each day's work, and display time management skills to accomplish assigned work. Must be able to work effectively in a remote work capacity. The associate must provide management with annual/biannual proof of certification and complete annual/biannual required continuing education. The associate will perform any other tasks as assigned.
$51k-64k yearly est. Auto-Apply 60d+ ago
VMG Risk Adjustment Coder - CRC within 6 months! (Remote)
Virtua 4.5
Remote
At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between - we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Location: 100% RemoteCurrently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only. Remote Type: Hybrid Employment Type: Employee Employment Classification: Regular Time Type: Full time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 40 Additional Locations: Job Information: CPC Required.CRC Required or must be obtained within 6 months of hire.HCC experience strongly preferred .Local candidates preferred due to occasional onsite requirements. Job Summary: Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). CRCs review provider documentation and communicates coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models. Position Responsibilities: Evaluates and analyzes medical records for proper documentation. Identifies and communicates coding deficiencies to clinicians in order to improve documentation for accurate risk adjustment coding. Provides on-going training and education to the clinicians and physicians during 1:1, physician group, performance improvement and ad hoc meetings. Manages and trends data collection for HCC and other risk coding. Performs data mining from data captured through risk adjustment coding. Works with Manager and Director of VMG Quality Department to strategize and prioritize chart reviews and education. Assists with the development of action plans to improve documentation. Completes chart reviews for various Values Based Programs focusing on annual review of suspect chronic conditions; utilizes payer portals as necessary to complete annual coding reviews. Position Qualifications Required: Required Experience: Minimum of two years records coding experience or equivalent Ability to perform functions in a Microsoft Windows environment Ability to be detailed oriented and perform tasks at a high level of accuracy Ability to make sound decisions Demonstrate good communication and team work skills Previous experience with an electronic legal health record system. Understand the anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses Understands medical coding guidelines and regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models Required Education: High School Diploma or GED required Knowledge of Anatomy & Physiology/ Medical terminology required Training / Certification / Licensure: CPC required Risk Adjustment Coder Certification (CRC) required or must obtain within six months of hire. Hourly Rate: $26.22 - $40.65 The actual salary/rate will vary based on applicant's experience as well as internal equity and alignment with market data.Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies. For more benefits information click here.
$26.2-40.7 hourly Auto-Apply 60d+ ago
Hospital Inpatient Coder
Franciscan Health Indianapolis 4.1
Remote
Work From HomeWork From Home Work From Home, Indiana 46544 The Coder VI Specialist- Hospital Inpatient analyzes the ICD 10 codes, suggested by computer assisted coding software, to ensure they align with official coding guidelines and the electronic medical record documentation. In collaboration with the Clinical Documentation Specialist, analyzes the circumstances of the visit to determine the most accurate diagnosis related group (DRG). This position also abstracts key data elements necessary for billing and data analysis. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Accurately review and code patient records in the following clinical areas: hospital acute inpatient services. Meet defined coding accuracy and production standards and demonstrate a thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, and Payor specific guidelines. Review and analyze the content of medical records to appropriately assign ICD diagnosis procedure codes, CPT procedure codes, and modifiers to meet coding guidelines. Notify coding leadership of trends and topics for education and feedback to physicians and departments. Identify and enter data elements for abstracting. Participate actively in performance improvement teams, projects, and committees. Serve as a Superuser and assist with system testing. Serve as a backup to coding reimbursement specialist. QUALIFICATIONS High School Diploma/GED - Required Associate's degree - Preferred 2 years Coding - Required CCS or RHIT - Required RHIT - Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Coder VI Specialist - Hospital Inpatient $22.70-$33.77INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
$54k-66k yearly est. Auto-Apply 53d ago
HIM Coder - Remote (Part Time 17 hours/week) CCS Required
Virtua 4.5
Remote
At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between - we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Location: 100% RemoteCurrently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only. Remote Type: 100% Remote Employment Type: Employee Employment Classification: Regular Time Type: Part time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 17 Additional Locations: Job Information: Please note all candidates must complete onsite testing in Marlton, NJ. Summary: Codes and abstracts hospital medical records (including Inpatients, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department) for diagnostic and procedural coding. Utilizes federal, state procedures/guidelines to assure accuracy of coding and abstracting and productivity standards. Collaborates with medical staff and clinical documentation improvement (CDI) staff to clarify documentation. Maintains performance in accordance with corporate compliance requirements as it pertains to the coding and abstracting of medical records, as well as Diagnosis Related Group (DRG) assignment. Position Responsibilities: Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4, and encoder to accurately code all significant diagnoses and procedures according to American Hospital Association (AHA), American Health Information Management Association (AHIMA), Uniform Hospital Discharge Data Set (UHDDS) hospital specific guidelines and rules/conventions. Records coded include Inpatient, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department. Sequences principal (or first-listed) diagnosis and principal procedures according to documentation found in the medical records and UHDDS definitions. Utilizes ongoing knowledge and reference material regarding DRGs to validate DRG assignments. Accurately utilizes written federal and state regulations and written guidelines regarding definitions and prioritizing of abstract data elements to assure uniformity of database. Records abstracted include Inpatient, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department. Verifies and/or abstracts required data into computer system according to procedure. Utilizes equipment and processes appropriately, to ensure efficient coding and abstracting; utilizes the established downtime procedures as needed. Participates in maintaining DNB and accounts receivable goal. Maintains department level competencies. Participates in performance improvement activities. Position Qualifications Required / Experience Required: Minimum of two years inpatient records coding experience Ability to perform functions in a Microsoft Windows environment Ability to be detailed oriented and perform tasks at a high level of accuracy Ability to make sound decisions Demonstrate good communication and teamwork skills Previous experience with an electronic legal health record system Required Education: High School Diploma or GED required Knowledge of Anatomy & Physiology/ Medical terminology required Coding education Training/Certifications/Licensure: AHIMA Certification: Certified Coding Specialist (CCS) required for all employees hired after 10/1/2025. Non-CCS-Certified Hourly Rate: $26.22 - $40.65 Hourly Rate: $27.80 - $43.12 The actual salary/rate will vary based on applicant's experience as well as internal equity and alignment with market data.Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies. For more benefits information click here.
$27.8-43.1 hourly Auto-Apply 56d ago
Coding Specialist I
Trihealth 4.6
Norwood, OH jobs
This position abstracts provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Job Requirements: High School Degree or GED CPC-A, CPC, CCS-P, CCA ICD-10-CM and CPT Coding Guidelines Medical terminology Anatomy Physiology Experience Related Fields Job Responsibilities: Assists with coding/billing questions from both internal and external customers. Which will include follow up on denials, research, review of charts for potential coding issues. Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary. Communicate with other clinical staff regarding documentation trends. Maintains a close working relationship with all departments and internal customers including leadership and consolidates effotrts to ensure appropriate and standardized coding procedures are followed. Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources. Maintains knowledge of current coding revisions and effectively communicates changes with provider. Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Other job-related information: Qualifications: Successful completion of a certification program from an accredited organization. Strong knowledge of anatomy, physiology, and medical terminology. Excellent typing and 10-key speed accuracy. Commitment to a high level of customer service. Superior mathmatical skills. Familarity with ICD-10 codes and procedures. Solid oral and written communication skills. Working knowledge of medical jargon and anatomy preferred. Able to work independently. Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Consistently Hearing: Conversation - Consistently Hearing: Other Sounds - Frequently Interpersonal Communication - Consistently Kneeling - Rarely Lifting Lifting 50+ Lbs - Rarely Lifting 11-50 Lbs - Rarely Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Consistently Standing - Frequently Stooping - Rarely Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Occasionally Color Vision - Rarely Visual Acuity: Far - Frequently Visual Acuity: Near - Frequently Walking - Occasionally TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone's opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community
$51k-62k yearly est. Auto-Apply 17d ago
Coding Specialist I
Trihealth, Inc. 4.6
Norwood, OH jobs
Job Overview: This position abstracts provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Job Requirements: High School Degree or GED CPC-A, CPC, CCS-P, CCA ICD-10-CM and CPT Coding Guidelines Medical terminology Anatomy Physiology Experience Related Fields Job Responsibilities: Assists with coding/billing questions from both internal and external customers. Which will include follow up on denials, research, review of charts for potential coding issues. Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary. Communicate with other clinical staff regarding documentation trends. Maintains a close working relationship with all departments and internal customers including leadership and consolidates effotrts to ensure appropriate and standardized coding procedures are followed. Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources. Maintains knowledge of current coding revisions and effectively communicates changes with provider. Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Other job-related information: Qualifications: Successful completion of a certification program from an accredited organization. Strong knowledge of anatomy, physiology, and medical terminology. Excellent typing and 10-key speed accuracy. Commitment to a high level of customer service. Superior mathmatical skills. Familarity with ICD-10 codes and procedures. Solid oral and written communication skills. Working knowledge of medical jargon and anatomy preferred. Able to work independently. Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Consistently Hearing: Conversation - Consistently Hearing: Other Sounds - Frequently Interpersonal Communication - Consistently Kneeling - Rarely Lifting Lifting 50+ Lbs - Rarely Lifting 11-50 Lbs - Rarely Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Consistently Standing - Frequently Stooping - Rarely Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Occasionally Color Vision - Rarely Visual Acuity: Far - Frequently Visual Acuity: Near - Frequently Walking - Occasionally TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… * Welcome everyone by making eye contact, greeting with a smile, and saying "hello" * Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist * Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… * Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met * Offer patients and guests priority when waiting (lines, elevators) * Work on improving quality, safety, and service Respect: ALWAYS… * Respect cultural and spiritual differences and honor individual preferences. * Respect everyone's opinion and contribution, regardless of title/role. * Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… * Value the time of others by striving to be on time, prepared and actively participating. * Pick up trash, ensuring the physical environment is clean and safe. * Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… * Acknowledge wins and frequently thank team members and others for contributions. * Show courtesy and compassion with customers, team members and the community
$51k-62k yearly est. 16d ago
Certified Coding Specialist (1.0)
Franciscan Health Indianapolis 4.1
Remote
Work From HomeWork From Home Work From Home, Indiana 46544 The Certified Coding Specialist upholds the critical responsibilities of reviewing electronic medical record (EMR) documentation, and applying ICD and CPT codes, per official coding guidelines, with a specific focus on professional primary care and urgent care visits. The position services as a subject matter expert to providers and staff for questions and updates related to coding. WHO WE ARE Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Review and audit EMR content, charts, CPT procedure codes, ICD diagnosis codes, and documentation to ensure accuracy and standard; provide corrective action if needed. Review MWV, TCM and CCM visits to ensure billing follows Medicare and coding guidelines. Verify insurance eligibility and update electronic medical record registration as appropriate. Demonstrates a thorough knowledge of coding guidelines, medical terminology, and anatomy/physiology, and payer specific coding guidelines. Communicate electronically with the provider and/or staff for documentation or clarification to support codes, and communicate concerns to the manager. QUALIFICATIONS High School Diploma/GED - Required Associate's Degree Health Information Management - Preferred 1 year of hands-on ICD-10 coding experience in a professional healthcare setting (not solely coursework or software training) - Preferred Highly detail-oriented with a commitment to accuracy - Required CPC, CCS, or CCA coding certification - Required TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Certified Coding Specialist $20.06-$26.81INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
$53k-63k yearly est. Auto-Apply 21d ago
Medical Biller II
Trihealth, Inc. 4.6
Norwood, OH jobs
Job Overview: The level II Medical Biller's general responsibilities include assisting the lead medical biller and fellow billing staff in submitting accurate clean claims, ensuring timely follow up. Collaboration with other teams will be needed to ensure denied claims are appealed as needed. Medical Biller II should be cross trained to work with different payers to help assist other billing staff. Reviews, investigates, and resolves credit balances. Medical Biller II will ensure the proper documentation in the facility's billing system. Responsible also for providing excellent customer service skills by answering patient and third party questions and/or addressing billing concerns in a timely and professional manner. Job Requirements: * High School Diploma or GED or GED (Required) * 3 - 4 years' experience in related field (Required) * Billing knowledge that includes ICD-9, ICD-10, and CPT terminology * Epic and Clearing House experience * Working knowledge of insurance policies and appeals Consistently meets individual productivity incentive standards Job Responsibilities: * Knowledge: Works with little supervisory oversight and exercises appropriate judgement in identifying payer trends. Identifies and appropriately communicates process improvement with team leaders and supervisors in a timely manner. Maintains a close working relationship with all departments and consolidates efforts to ensure appropriate and standardized coding/billing procedures are followed. * Quality Review: Consistently produces quality work and actions to move a claim to proper payment or account resolution while maintaining assigned work queues. * Personal Productivity: Completes assigned workload based on key performance indicators on a daily basis to ensure standard productivity is met. * Patient Accounting Cash: Meet or exceed approved target; collect 100% of net revenue booked based on remittance. * Aging: Decrease AR greater than 90 days for Insurance accounts as set by department each year. Lower is better. Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Frequently Hearing: Conversation - Frequently Hearing: Other Sounds - Rarely Interpersonal Communication - Rarely Kneeling - Rarely Lifting Lifting 50+ Lbs. - Rarely Lifting Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Consistently Standing - Frequently Stooping - Rarely Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Consistently Color Vision - Frequently Visual Acuity: Far - Consistently Visual Acuity: Near - Consistently Walking - Frequently TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS... * Welcome everyone by making eye contact, greeting with a smile, and saying "hello" * Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist * Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS... * Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met * Offer patients and guests priority when waiting (lines, elevators) * Work on improving quality, safety, and service Respect: ALWAYS... * Respect cultural and spiritual differences and honor individual preferences. * Respect everyone's opinion and contribution, regardless of title/role. * Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS... * Value the time of others by striving to be on time, prepared and actively participating. * Pick up trash, ensuring the physical environment is clean and safe. * Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS... * Acknowledge wins and frequently thank team members and others for contributions. * Show courtesy and compassion with customers, team members and the community
$32k-37k yearly est. 16d ago