JOB SUMMARY

The Coder 3 is proficient in at least one of the following: high acuity inpatient, all hospital based outpatient , or Profee as follows: high acuity profee service lines, Cardiac Cath/Electrophysiology (EP) or Interventional Radiology (IR) with a CIRCC certification, or expertise in at least 8 different sub-specialities. Coder 3 utilizes the International Classification of Disease (ICD-10-CM. ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.) The Coder 3 will abstract and enter required data.

ESSENTIAL FUNCTIONS OF THE ROLE

• Reviews and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees.
• Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
• Communicates with providers for missing documentation elements and offers guidance and education when needed.
• Reconciles billing issues by formulating the rationale for rejecting and correcting inaccurate charges.
• Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.
• Reviews and edits charges.

KEY SUCCESS FACTORS

• Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
• Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
• Sound knowledge of anatomy, physiology, and medical terminology.
• Demonstrated expertise of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
• Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
• Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
• Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.

Must have 1 of the following certifications:

• Registered Health Information Administrator (RHIA)
• Registered Health Information Technologist (RHIT)
• Certified Coding Specialist (CCS)
• Certified Coding Specialist Physician-based (CCS-P)
• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Inpatient Coder (CIC)
• Certified Interventional Radiology Cardiovascular Coder (CIRCC)

BENEFITS

Our competitive benefits package includes the following:

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note: Benefits may vary based on position type and/or level

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 3 Years of Experience
• CERTIFICATION/LICENSE/REGISTRATION
  • Cert Coding Specialist (CCS)
  • Cert Coding Spec Physician Bas (CCS-P)
  • Cert Inpatient Coder (CIC)
  • Cert Interv Radiology CV Coder (CIRCC)
  • Cert Outpatient Coder (COC)
  • Cert Professional Coder (CPC)
  • Reg Health Info Administrator (RHIA), Reg Health Information Technic (RHIT)