Medical Coder jobs at St. Luke's Health System

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Seeking candidates with surgical Gastroenterology coding experience Job Summary Summary Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations. Does this position require Patient Care? No Essential Functions: Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information. * Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies. * Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes. * Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials. * Utilize coding software, encoders, and electronic health record systems to facilitate the coding process. * Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives. * Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges. Qualifications Education High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred Licenses and Credentials Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred Experience Medical Coding Experience 3-5 years required Knowledge, Skills and Abilities * In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing. * Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations. * Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes. * Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding. * Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff. * Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range * / Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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.

is 100% Remote for Washington State Only. Under general supervision, the Inpatient Hospital Coder is responsible for the collection of relevant, pertinent, accurate and timely ICD-10 diagnosis and PCS procedural codes based on inpatient coding guidelines. Requires abstracting from inpatient hospital case types including low and moderate complexity cases (psychiatric care, general medicine, endocrine, chemotherapy, gastroenterology, surgical, cardiac, orthopedic, etc.). Requires basic understanding of DRG grouping and the uniform hospital discharge data set (UHDDS). Requires effective use of hospital encoding systems and resources as well as recognizing what data can be abstracted, presented, and interpreted for effective use throughout the hospital data cycle. Responsible for resolving coding validation and claim edits based on regulatory and compliant processes. Performs other duties as assigned. Required Education and Experience Associate degree or two years of college coursework in Health Information Management (HIM) or equivalent work experience. Minimum of 1 year inpatient facility coding experience, including PCS (Procedure Coding System) code assignment OR minimum of 3 years outpatient facility coding experience with at least 1 year of facility coding in an acute care pediatric setting and completion of a PCS training program. Required Credentials • AHIMA - CCS or RHIT/RHIA and agreement and eligibility to obtain CCS within 6 months of hire or • AAPC - CIC or CPC/COC and agreement and eligibility to obtain CIC within 6 months of hire Preferred • CCS or CIC at time of hire • Experience in a pediatric acute care setting Compensation Range $32.07 - $48.11 per hour Salary Information This compensation range was calculated based on full-time employment (2080 hours worked per calendar year). Offers are determined by multiple factors including equity, skills, experience, and expertise, and may vary within the range provided. Disclaimer for Out of State Applicants This compensation range is specific to Seattle, positions located outside of Seattle may be compensated differently depending on various factors. Benefits Information Seattle Children's offers a generous benefit package, including medical, dental, and vision plans, 403(b), life insurance, paid time off, tuition reimbursement, and more. Additional details on our benefits can be found on our website ****************************************** About Us Hope. Care. Cure. These three simple words capture what we do at Seattle Children's - to help every child live the healthiest and most fulfilling life possible. Are you ready to engage with a mission-driven organization that is life-changing to many, and touches the hearts of all? #HOPECARECURE Our founding promise to the community is as valid today as it was over a century ago: we will care for all children in our region, regardless of the families' ability to pay. Together, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho - the largest region of any children's hospital in the country. U.S. News & World Report consistently ranks Seattle Children's among the nation's best children's hospitals. For more than a decade, Seattle Children's has been nationally recognized in key specialty areas. We are honored to be one of the nation's very best places to care for children and the top-ranked pediatric hospital in Washington and the Pacific Northwest. As a Magnet designated institution, we recognize the importance of hiring and developing great talent to provide best-in-class care to the patients and families we serve. Our organizational DNA takes form in our core values: Compassion, Excellence, Integrity, Collaboration, Equity and Innovation. Whether it's delivering frontline care to our patients in a kind and caring manner, practicing the highest standards of quality and safety, or being relentlessly curious as we work towards eradicating childhood diseases, these values are the fabric of our culture and community. The future starts here. Our Commitment Seattle Children's welcomes people of all experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our patients and families. Our organization recruits, employs, trains, compensates, and promotes based on merit without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. The people who work at Seattle Children's are members of a community that seeks to respect and celebrate all the qualities that make each of us unique. Each of us is empowered to be ourselves. Seattle Children's is proud to be an Equal Opportunity Workplace and Affirmative Action Employer.

Inspire health. Serve with compassion. Be the difference. Responsible for validating/reviewing front end coding edits and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues. Essential Functions * All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. * Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. * Utilizes appropriate coding software and coding resources in order to determine correct codes. * Responsible for resolving all assigned pre-billing edits. Communicates billing related issues to assigned supervisor/manager and participates in meetings to improve overall billing process * Provides feedback to providers in order to clarify and resolve coding concerns. * Assists in identifying areas that require additional training. * Performs other duties as assigned. Supervisory/Management Responsibilities * This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements * Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred * Experience - No experience required. Professional billing, coding, healthcare experience (ex. phlebotomy, surgical tech, etc.) preferred. In Lieu Of * NA Required Certifications, Registrations, Licenses * Certified Professional Coder-CPC or CPC-A Knowledge, Skills and Abilities * Maintain knowledge of governmental and commercial payer guidelines. * Participates in coding educational opportunities (webinars, in house training, etc.). * Knowledge of office equipment (fax/copier) * Proficient computer skills including word processing, spreadsheets, database * Data entry skills * Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Inspire health. Serve with compassion. Be the difference. Responsible for validating/reviewing front end coding edits and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Responsible for resolving all assigned pre-billing edits. Communicates billing related issues to assigned supervisor/manager and participates in meetings to improve overall billing process Provides feedback to providers in order to clarify and resolve coding concerns. Assists in identifying areas that require additional training. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - No experience required. Professional billing, coding, healthcare experience (ex. phlebotomy, surgical tech, etc.) preferred. In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder-CPC or CPC-A Knowledge, Skills and Abilities Maintain knowledge of governmental and commercial payer guidelines. Participates in coding educational opportunities (webinars, in house training, etc.). Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Inspire health. Serve with compassion. Be the difference. Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims. All team members are expected to be knowledgeable of payer guidelines related to coding and appeal timelines. Communicates with providers regarding coding denial issues. Ensures documentation supports CPT, Modifiers, HCPCS and ICD-10 codes for submitted appeals, reopenings, reconsiderations, etc. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues Follows departmental policies for charge corrections. Participates in coding educational opportunities (webinars, in house training, etc.). Provides feedback to providers or appropriate office liaison in order to clarify and resolve coding concerns. Submits appeals for assigned payer and/or division. Assists with Compliance Team and Coding Educators to identify areas that require additional training Participates in meetings in order to improve overall billing Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - Two (2) years professional coding and/or billing experience In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder-CPC Knowledge, Skills and Abilities Maintains knowledge of governmental and commercial payer guidelines. Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Inspire health. Serve with compassion. Be the difference. Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims. All team members are expected to be knowledgeable of payer guidelines related to coding and appeal timelines. Communicates with providers regarding coding denial issues. Ensures documentation supports CPT, Modifiers, HCPCS and ICD-10 codes for submitted appeals, reopenings, reconsiderations, etc. Essential Functions * All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. * Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals. * Utilizes appropriate coding software and coding resources in order to determine correct codes. * Communicates billing related issues * Follows departmental policies for charge corrections. * Participates in coding educational opportunities (webinars, in house training, etc.). * Provides feedback to providers or appropriate office liaison in order to clarify and resolve coding concerns. * Submits appeals for assigned payer and/or division. * Assists with Compliance Team and Coding Educators to identify areas that require additional training * Participates in meetings in order to improve overall billing * Performs other duties as assigned. Supervisory/Management Responsibilities * This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements * Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred * Experience - Two (2) years professional coding and/or billing experience In Lieu Of * NA Required Certifications, Registrations, Licenses * Certified Professional Coder-CPC Knowledge, Skills and Abilities * Maintains knowledge of governmental and commercial payer guidelines. * Knowledge of office equipment (fax/copier) * Proficient computer skills including word processing, spreadsheets, database * Data entry skills * Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **· Certified Risk Adjustment Coder (CRC) required** · Excellent verbal and written communication skills. · Customer service-oriented attitude/behavior. · Detail oriented with the ability to multi-task and complete tasks in a timely manner. · Ability to work well as a team member. · Intermediate computer skills: typing, 10-key, Word, Excel, Outlook and Teams. · High School Diploma or GED **ESSENTIAL FUNCTIONS:** Meets Health System's Guiding Behaviors and Caring Standards including interpersonal communication and professional conduct expectations with all coworkers, other departments, and with patients and visitors. Accurately codes (ICD-10-CM) to the most appropriate level of specificity. Follows current industry standards of ethical coding. Recognizes and reports opportunities for documentation improvement to the Supervisor of Risk Adjustment Coding & Audit to develop and implement provider documentation improvement plans. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations. Participates in continuing education activities to maintain their certification(s) and pertinent to areas of job responsibility. Performs additional duties as assigned. Adheres to St. Peter's Health Partners' confidentiality requirements as they relate to patient information. What a Certified Risk Adjustment Coding Specialist will do: · Review and assigns accurate ICD-10-CM codes for diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system work queues and natural language processing (NLP) tools to support addressing HCC codes for Risk Adjustment before a claim is submitted to payers. · Demonstrate a solid understanding of ICD-10-CM coding and medical terminology, Hierarchical Condition Category (HCC), and M.E.A.T standards. · Exercise thorough understanding of ICD-10-CM coding guidelines, payer regulations, compliance and reimbursement and the effects of coding in relation to risk adjustment payment models. · Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers. **Core Values:** · Reverence: We honor the sacredness and dignity of every person. · Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable. · Justice: We foster right relationships to promote the common good, including sustainability of Earth. · Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care. · Integrity We are faithful to those we say we are. · Safety: We embrace a culture that prevents harm and nurtures a healing, safe environment for all. **PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS** · Must be able to set and organize own work priorities and adapt to them as they change frequently. · Must be able to work concurrently on a variety of tasks/projects in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles. · Must possess the ability to comply with Trinity Health policies and procedures. · Must be able to spend majority of work time utilizing a computer, monitor, and keyboard. · Must be able to perform some lifting and/or pushing/pulling up to 20 pounds if applicable. · Must be able to work with interruptions and perform detailed tasks. · If applicable, involves a wide array of physical activities, primarily walking, standing, balancing, sitting, squatting, and reading. Must be able to sit for long periods of time. · 100% remote but if local may include some travel to sites. · Must be able to travel to various Trinity Health sites (10%) as applicable. · If applicable, telecommuting (working remotely), must be able to comply with Trinity Health's and the Region/RHM Working Remote Policy. · Please be aware for the safety and security of our colleagues and patients all new employees are required to undergo and pass all applicable state and federally mandated pre-employment screening requirements including: Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. Pay range: $24.60-$35.70 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location **Our Commitment** Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability/veteran

The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: * Certified Risk Adjustment Coder (CRC) required * Excellent verbal and written communication skills. * Customer service-oriented attitude/behavior. * Detail oriented with the ability to multi-task and complete tasks in a timely manner. * Ability to work well as a team member. * Intermediate computer skills: typing, 10-key, Word, Excel, Outlook and Teams. * High School Diploma or GED ESSENTIAL FUNCTIONS: Meets Health System's Guiding Behaviors and Caring Standards including interpersonal communication and professional conduct expectations with all coworkers, other departments, and with patients and visitors. Accurately codes (ICD-10-CM) to the most appropriate level of specificity. Follows current industry standards of ethical coding. Recognizes and reports opportunities for documentation improvement to the Supervisor of Risk Adjustment Coding & Audit to develop and implement provider documentation improvement plans. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations. Participates in continuing education activities to maintain their certification(s) and pertinent to areas of job responsibility. Performs additional duties as assigned. Adheres to St. Peter's Health Partners' confidentiality requirements as they relate to patient information. What a Certified Risk Adjustment Coding Specialist will do: * Review and assigns accurate ICD-10-CM codes for diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system work queues and natural language processing (NLP) tools to support addressing HCC codes for Risk Adjustment before a claim is submitted to payers. * Demonstrate a solid understanding of ICD-10-CM coding and medical terminology, Hierarchical Condition Category (HCC), and M.E.A.T standards. * Exercise thorough understanding of ICD-10-CM coding guidelines, payer regulations, compliance and reimbursement and the effects of coding in relation to risk adjustment payment models. * Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers. Core Values: * Reverence: We honor the sacredness and dignity of every person. * Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable. * Justice: We foster right relationships to promote the common good, including sustainability of Earth. * Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care. * Integrity We are faithful to those we say we are. * Safety: We embrace a culture that prevents harm and nurtures a healing, safe environment for all. PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS * Must be able to set and organize own work priorities and adapt to them as they change frequently. * Must be able to work concurrently on a variety of tasks/projects in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles. * Must possess the ability to comply with Trinity Health policies and procedures. * Must be able to spend majority of work time utilizing a computer, monitor, and keyboard. * Must be able to perform some lifting and/or pushing/pulling up to 20 pounds if applicable. * Must be able to work with interruptions and perform detailed tasks. * If applicable, involves a wide array of physical activities, primarily walking, standing, balancing, sitting, squatting, and reading. Must be able to sit for long periods of time. * 100% remote but if local may include some travel to sites. * Must be able to travel to various Trinity Health sites (10%) as applicable. * If applicable, telecommuting (working remotely), must be able to comply with Trinity Health's and the Region/RHM Working Remote Policy. * Please be aware for the safety and security of our colleagues and patients all new employees are required to undergo and pass all applicable state and federally mandated pre-employment screening requirements including: Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. Pay range: $24.60-$35.70 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Employment Type:Full time Shift:Day ShiftDescription: Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: · Certified Risk Adjustment Coder (CRC) required · Excellent verbal and written communication skills. · Customer service-oriented attitude/behavior. · Detail oriented with the ability to multi-task and complete tasks in a timely manner. · Ability to work well as a team member. · Intermediate computer skills: typing, 10-key, Word, Excel, Outlook and Teams. · High School Diploma or GED ESSENTIAL FUNCTIONS: Meets Health System's Guiding Behaviors and Caring Standards including interpersonal communication and professional conduct expectations with all coworkers, other departments, and with patients and visitors. Accurately codes (ICD-10-CM) to the most appropriate level of specificity. Follows current industry standards of ethical coding. Recognizes and reports opportunities for documentation improvement to the Supervisor of Risk Adjustment Coding & Audit to develop and implement provider documentation improvement plans. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations. Participates in continuing education activities to maintain their certification(s) and pertinent to areas of job responsibility. Performs additional duties as assigned. Adheres to St. Peter's Health Partners' confidentiality requirements as they relate to patient information. What a Certified Risk Adjustment Coding Specialist will do: · Review and assigns accurate ICD-10-CM codes for diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system work queues and natural language processing (NLP) tools to support addressing HCC codes for Risk Adjustment before a claim is submitted to payers. · Demonstrate a solid understanding of ICD-10-CM coding and medical terminology, Hierarchical Condition Category (HCC), and M.E.A.T standards. · Exercise thorough understanding of ICD-10-CM coding guidelines, payer regulations, compliance and reimbursement and the effects of coding in relation to risk adjustment payment models. · Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers. Core Values: · Reverence: We honor the sacredness and dignity of every person. · Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable. · Justice: We foster right relationships to promote the common good, including sustainability of Earth. · Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care. · Integrity We are faithful to those we say we are. · Safety: We embrace a culture that prevents harm and nurtures a healing, safe environment for all. PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS · Must be able to set and organize own work priorities and adapt to them as they change frequently. · Must be able to work concurrently on a variety of tasks/projects in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles. · Must possess the ability to comply with Trinity Health policies and procedures. · Must be able to spend majority of work time utilizing a computer, monitor, and keyboard. · Must be able to perform some lifting and/or pushing/pulling up to 20 pounds if applicable. · Must be able to work with interruptions and perform detailed tasks. · If applicable, involves a wide array of physical activities, primarily walking, standing, balancing, sitting, squatting, and reading. Must be able to sit for long periods of time. · 100% remote but if local may include some travel to sites. · Must be able to travel to various Trinity Health sites (10%) as applicable. · If applicable, telecommuting (working remotely), must be able to comply with Trinity Health's and the Region/RHM Working Remote Policy. · Please be aware for the safety and security of our colleagues and patients all new employees are required to undergo and pass all applicable state and federally mandated pre-employment screening requirements including: Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. Pay range: $24.60-$35.70 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Employment Type:Part time Shift:Description: This position is responsible for training new staff on systems used for coding, as well as, being a resource for all coding staff to ensuring the accurate coding of diagnoses and operative procedures for statistical, reimbursement, and OSHPD purposes and for abstracting and analyzing all discharged and/or outpatient surgery records (i.e., inpatient, emergency room, outpatient medical and outpatient surgery). REQUIREMENTS 1. High school diploma or equivalent is required. 2. Five (5) years of coding experience in an acute care facility using ICD-10-CM and CPT coding and/or DRG assignment is required. 3. Knowledge and experience with medical terminology, anatomy, physiology, and general office practices, as well as familiarity with state and federal laws governing the release of medical information is required. 4. RHIA, RHIT or CCS certification is required. Pay Range $35.13 - $47.42 Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

This position is responsible for training new staff on systems used for coding, as well as, being a resource for all coding staff to ensuring the accurate coding of diagnoses and operative procedures for statistical, reimbursement, and OSHPD purposes and for abstracting and analyzing all discharged and/or outpatient surgery records (i.e., inpatient, emergency room, outpatient medical and outpatient surgery). **REQUIREMENTS** 1. High school diploma or equivalent is required. 2. Five (5) years of coding experience in an acute care facility using ICD-10-CM and CPT coding and/or DRG assignment is required. 3. Knowledge and experience with medical terminology, anatomy, physiology, and general office practices, as well as familiarity with state and federal laws governing the release of medical information is required. 4. RHIA, RHIT or CCS certification is required. Pay Range $35.13 - $47.42 **Our Commitment** Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability/veteran

This position is responsible for training new staff on systems used for coding, as well as, being a resource for all coding staff to ensuring the accurate coding of diagnoses and operative procedures for statistical, reimbursement, and OSHPD purposes and for abstracting and analyzing all discharged and/or outpatient surgery records (i.e., inpatient, emergency room, outpatient medical and outpatient surgery). REQUIREMENTS 1. High school diploma or equivalent is required. 2. Five (5) years of coding experience in an acute care facility using ICD-10-CM and CPT coding and/or DRG assignment is required. 3. Knowledge and experience with medical terminology, anatomy, physiology, and general office practices, as well as familiarity with state and federal laws governing the release of medical information is required. 4. RHIA, RHIT or CCS certification is required. Pay Range $35.13 - $47.42 Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Incumbent(s) operate under the general supervision of HIM Coding leadership. Applies ICD and ICD-PCS codes to inpatient records, including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the optimal principal diagnoses with appropriate POA indicator assignment and sequencing of risk adjustment diagnoses following established guidelines. Reviews work queues to identify charts that need to be coded and prioritizes as per department-specific guidelines and within designated timelines. Follows up on On-hold accounts daily for final coding. Identifies and requests physician queries following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management (AHIMA) guidelines and established organization policies. Ensures all open queries initiated by Clinical Documentation Specialists have been addressed prior to final coding. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Adheres to department standards for productivity and accuracy. Identifies and trends coding issues escalating identified concerns Consults, provides professional expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - Certification Program or Associate degree or Coding Certificate through American Health Information Management (AHIMA) or other approved coding certification program. Experience - Three (3) years coding experience in an acute care or ambulatory setting. Inpatient coding experience. EPIC health information system experiences preferred. In Lieu Of In lieu of education and experience requirements noted above, successful completion of the IP Coder Associate program or coder associate may be considered. Required Certifications, Registrations, Licenses Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. Knowledge, Skills and Abilities Participates in on site, remote and/or external training workshops and training. Attends and participates in CDI-Coding Task Force and other collaborative training and education with CDI, PFS and Quality. Demonstrates proficiency in utilizing official coding books as well as the electronic medical record, computer assisted coding/encoding software, and clinical documentation information systems to facilitate coding assignment. Knowledge of electronic medical records and 3M or Encoder System. Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. Knowledge of MS DRG prospective payment system and severity systems. Ability to concentrate for extended periods of time. Ability to work and make decisions independently. Work Shift Day (United States of America) Location 5 Medical Park Rd Richland Facility 7001 Corporate Department 70017512 HIM-Coding Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Inspire health. Serve with compassion. Be the difference. Codes medical information into the organization billing/abstracting systems and to complete the coding function through established best practice processes and professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Data reported by this incumbent is used to meet licensure requirements, is used for statistical purposes, and for financial and billing purposes. Incumbent(s) operate under the general supervision of HIM Coding leadership. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Applies ICD and ICD-PCS codes to inpatient records, including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the optimal principal diagnoses with appropriate POA indicator assignment and sequencing of risk adjustment diagnoses following established guidelines. Reviews work queues to identify charts that need to be coded and prioritizes as per department-specific guidelines and within designated timelines. Follows up on On-hold accounts daily for final coding. Identifies and requests physician queries following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management (AHIMA) guidelines and established organization policies. Ensures all open queries initiated by Clinical Documentation Specialists have been addressed prior to final coding. Adheres to department standards for productivity and accuracy. Identifies and trends coding issues escalating identified concerns Consults, provides professional expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - Certification Program or Associate degree or Coding Certificate through American Health Information Management (AHIMA) or other approved coding certification program. Experience - Three (3) years coding experience in an acute care or ambulatory setting. Inpatient coding experience. EPIC health information system experiences preferred. In Lieu Of In lieu of education and experience requirements noted above, successful completion of the IP Coder Associate program or coder associate may be considered. Required Certifications, Registrations, Licenses Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. Knowledge, Skills and Abilities Participates in on site, remote and/or external training workshops and training. Attends and participates in CDI-Coding Task Force and other collaborative training and education with CDI, PFS and Quality. Demonstrates proficiency in utilizing official coding books as well as the electronic medical record, computer assisted coding/encoding software, and clinical documentation information systems to facilitate coding assignment. Knowledge of electronic medical records and 3M or Encoder System. Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. Knowledge of MS DRG prospective payment system and severity systems. Ability to concentrate for extended periods of time. Ability to work and make decisions independently. Work Shift Day (United States of America) Location Corporate Facility 7001 Corporate Department 70017512 HIM Coding Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions * All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. * Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. * Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Incumbent(s) operate under the general supervision of HIM Coding leadership. * Applies ICD and ICD-PCS codes to inpatient records, including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the optimal principal diagnoses with appropriate POA indicator assignment and sequencing of risk adjustment diagnoses following established guidelines. * Reviews work queues to identify charts that need to be coded and prioritizes as per department-specific guidelines and within designated timelines. Follows up on On-hold accounts daily for final coding. * Identifies and requests physician queries following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management (AHIMA) guidelines and established organization policies. Ensures all open queries initiated by Clinical Documentation Specialists have been addressed prior to final coding. * Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Adheres to department standards for productivity and accuracy. Identifies and trends coding issues escalating identified concerns * Consults, provides professional expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. * Performs other duties as assigned. Supervisory/Management Responsibilities * This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements * Education - Certification Program or Associate degree or Coding Certificate through American Health Information Management (AHIMA) or other approved coding certification program. * Experience - Three (3) years coding experience in an acute care or ambulatory setting. Inpatient coding experience. EPIC health information system experiences preferred. In Lieu Of * In lieu of education and experience requirements noted above, successful completion of the IP Coder Associate program or coder associate may be considered. Required Certifications, Registrations, Licenses * Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. Knowledge, Skills and Abilities * Participates in on site, remote and/or external training workshops and training. Attends and participates in CDI-Coding Task Force and other collaborative training and education with CDI, PFS and Quality. * Demonstrates proficiency in utilizing official coding books as well as the electronic medical record, computer assisted coding/encoding software, and clinical documentation information systems to facilitate coding assignment. * Knowledge of electronic medical records and 3M or Encoder System. * Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. * Knowledge of MS DRG prospective payment system and severity systems. * Ability to concentrate for extended periods of time. * Ability to work and make decisions independently. Work Shift Day (United States of America) Location 5 Medical Park Rd Richland Facility 7001 Corporate Department 70017512 HIM-Coding Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Hospital Coding Specialist III (Remote) Cost Center:101651098 System Support-Facility CodingScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description: **May be eligible for a sign-on bonus!** JOB SUMMARY The Hospital Coding Specialist III accurately codes inpatient conditions and procedures as documented in the International Classification of Diseases (ICD) Official Guidelines for Coding and Reporting and in the Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG (Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related Groups) for complex, multi-specialty inpatient services. This individual understands and applies applicable medical terminology, anatomy and physiology, surgical technology, pharmacology and disease processes. The Hospital Coding Specialist III reviews professional and hospital inpatient medical record documentation and properly identifies and assigns: ICD CM and PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions, surgical procedures and/or other procedures. MS-DRG /APR-DRG Present on admission indicators HAC (Hospital Acquired conditions) and when required, report through established procedures PSI conditions and report through established procedures Discharge Disposition code Works collaboratively with the Clinical Documentation Improvement Specialists to address documentation concerns and DRG assignments Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding and DRG assignments as requested JOB QUALIFICATIONS EDUCATION The individual applying must meet the minimum qualifications in all three required sections below to be considered a candidate for interview. Please consider when listing minimum qualifications. Minimum Required: AHIMA or AAPC approved Medical Coding Diploma or Health Information Management Degree or related program. Preferred/Optional: None EXPERIENCE Minimum Required: Three years of progressive inpatient coding experience in an acute care facility. Preferred/Optional: Experience with electronic health record systems. Academic or level I or II trauma experience is a plus. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position Minimum Required: Active credential of Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) through the American Health Information Management Association (AHIMA); or AAPC (American Academy of Professional Coders) at the time of hire. Preferred/Optional: If AAPC credential, preferred is CIC (Certified Inpatient Coder). **May be eligible for a sign-on bonus!** Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states: Alabama (limitations in some counties) Arizona (limitations in some counties) Arkansas Colorado (limitations in some counties) Florida Georgia Idaho Illinois (limitations in some counties) Indiana Iowa Kansas Kentucky (limitations in some counties) Louisiana Maine (limitations in some counties) Michigan Minnesota (limitations in some counties) Mississippi Missouri Montana Nebraska Nevada New Hampshire (limitations in some counties) North Carolina North Dakota Ohio Oklahoma Oregon (limitations in some counties) Pennsylvania (limitations in some counties) South Carolina South Dakota Tennessee Texas (limitations in some counties) Utah Virginia Wisconsin Wyoming Marshfield Clinic Health System will not employ individuals living in states not listed above. Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

**Status:** Full time Remote The primary purpose of this position is to assign ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical records and providing education on documentation to support HCCs. **Position Details:** This is a fully remote position. Work hours will be 8 to 430 or 7 to 330 Eastern. Training will take place in person in Livonia, MI for one week (expenses paid). Onsite training is required for position. Onsite training would take place during the 2nd week of employment. **What you will do:** + Evaluate medical records to identify diagnoses and procedures and accurately assigns and sequences ICD and CPT codes. Abstracts and validates information. Seeks out validating information as needed. + Conduct documentation spot checks and respond to audit feedback. + Ensure timely, accurate client care documentation for billing. + Monitors and informs manager of records that are not completed timely. Monitors, investigates and takes appropriate action for records that are not coded, billed, or rejected. + Stay updated on coding guidelines and reimbursement requirements. + Maintains participant confidentiality and abides by HIPAA guidelines. + Assures site staff compliance with federal/state and accreditation regulations through record review, case conferencing and communication. **Minimum Qualifications:** + High school diploma or equivalent required. + 2 years of completed college coursework preferred. + **Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA** + **Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year if hired.** + **Two-years of experience in a risk adjustment coding environment required.** + Demonstrated the ability to verify and validate HCCs. + Demonstrated the knowledge and ability to work with providers on education and guidance. + Demonstrated knowledge of medical terminology, human anatomy and physiology, and diseases processes. + Strong communication, problem-solving, customer service, critical thinking, and organizational skills. + Comprehensive proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); Ability to use other software as required to perform the essential functions of the job. + Ability to prioritize workload. + Position may require occasional travel to home office in Livonia, MI or other supported locations. **Position Highlights and Benefits:** + Comprehensive benefit including 1st Day medical coverage, dental, vision, paid time off, 403B and educational assistance. + Access to daily pay and employee referral incentives. + Supportive environment with a patient-centered focus. + Opportunities for professional development. **Ministry/Facility Information** **Trinity Health PACE** provides high-quality care to seniors in the communities we serve. Our interdisciplinary team offers comprehensive services, allowing seniors to remain independent at home. We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity. Apply now! Min Pay: 24.00 Max Pay: 30.00 **Our Commitment** Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability/veteran

Status: Full time Remote The primary purpose of this position is to assign ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical records and providing education on documentation to support HCCs. Position Details: This is a fully remote position. Work hours will be 8 to 430 or 7 to 330 Eastern. Training will take place in person in Livonia, MI for one week (expenses paid). Onsite training is required for position. Onsite training would take place during the 2nd week of employment. What you will do: * Evaluate medical records to identify diagnoses and procedures and accurately assigns and sequences ICD and CPT codes. Abstracts and validates information. Seeks out validating information as needed. * Conduct documentation spot checks and respond to audit feedback. * Ensure timely, accurate client care documentation for billing. * Monitors and informs manager of records that are not completed timely. Monitors, investigates and takes appropriate action for records that are not coded, billed, or rejected. * Stay updated on coding guidelines and reimbursement requirements. * Maintains participant confidentiality and abides by HIPAA guidelines. * Assures site staff compliance with federal/state and accreditation regulations through record review, case conferencing and communication. Minimum Qualifications: * High school diploma or equivalent required. * 2 years of completed college coursework preferred. * Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA * Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year if hired. * Two-years of experience in a risk adjustment coding environment required. * Demonstrated the ability to verify and validate HCCs. * Demonstrated the knowledge and ability to work with providers on education and guidance. * Demonstrated knowledge of medical terminology, human anatomy and physiology, and diseases processes. * Strong communication, problem-solving, customer service, critical thinking, and organizational skills. * Comprehensive proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); Ability to use other software as required to perform the essential functions of the job. * Ability to prioritize workload. * Position may require occasional travel to home office in Livonia, MI or other supported locations. Position Highlights and Benefits: * Comprehensive benefit including 1st Day medical coverage, dental, vision, paid time off, 403B and educational assistance. * Access to daily pay and employee referral incentives. * Supportive environment with a patient-centered focus. * Opportunities for professional development. Ministry/Facility Information Trinity Health PACE provides high-quality care to seniors in the communities we serve. Our interdisciplinary team offers comprehensive services, allowing seniors to remain independent at home. We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity. Apply now! Min Pay: 24.00 Max Pay: 30.00 Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.