Coder II, Surgery and E&M Coding, Remote

Address Home Office Remote, KY 40601 Shift First Shift (United States of America)

Job Description

Summary TBD

Job Description

The Coder II is responsible for abstracting and assigning valid CPT, ICD-10, HCPCs and modifiers to ensure appropriate reimbursement in accordance with federal, state, and private health plans as well as organization and regulatory guidance. This position is responsible for identifying compliance concerns, trends, and education opportunities to ensure proper coding, documentation, and accuracy of billing within their areas or responsibility/specialty. The Coder II will work independently with limited oversight and may require direction from supervisor or more senior co-workers on complex cases. Essential Functions:

• Accurately abstracts information from the service documentation, assigns appropriate CPT, ICD-10, HCPCs codes into the appropriate billing systems, ensuring compliance with established guidelines
• Identifies and communicates deficiencies that impact the billing process
• Completes encounters in the coding work queue or reports in a timely manner
• Identifies trends and educational opportunities to ensure proper coding, documentation, and accuracy of billing within areas of responsibility/specialty
• Reviews and resolves denials
• Ensures documentation meets current EM Guidelines for Providers
• Ensures documentation meets Teaching Physician Rules as mandated by the Center for Medicare and Medicaid Services (CMS) and UofL Health policies prior to release of a code for billing.
• Ensures documentation for Advanced Practice Providers meets payer specific rules prior to release of a code for billing
• Provides comments/suggestion relative to weak areas identified in the coding reviews
• Provides trending deficiencies to Senior Manager and Compliance Educator, as appropriate
• Assists Coder Lead or Supervisor in training and mentoring staff.

Communicates professionally with providers, practice management, and other stake holders either verbally or in writing

• Meets or exceeds organization coding production and quality standards
• Participates in special projects and completes duties as assigned
• Develop daily/weekly communication with office managers, department, and providers.
• Responds in a timely manner to questions from manager, providers, department, and representative
• Maintains compliance with rules and regulations regarding coding
• Ability to work within a team environment and meet monthly goals
• Maintains compliance with all company policies, procedures and standards of conduct
• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
• Performs other duties as assigned.

Additional Job Description Job Requirements (Education, Experience, Licensure and Certification) Education:

• High school diploma or GED/equivalent (required) Experience:
• Three (3) years of coding experience (required)
• Previous Electronic Health Record Experience (preferred) Certification:
• Certified Professional Coder (CPC) accredited by the American Academy of Professional Coders (AAPC) (required)
• Certified Coding Specialist (CCS) or Certified Coding Specialists Based (CCS-P) accredited by the American Health Information Management Association (AHIMA) (required) Job Competency: Knowledge, Skills, and Abilities critical to this role:
• Advanced knowledge of medical codes involving selections of most accurate and description code using the ICD 10, CPT, HCPC, and IHS coding conventions
• Understands and applies regulatory changes and stays current with coding updates, including NCCI and MUE edits.

Advanced working knowledge of anatomy and physiology, disease process and medical terminology

• Advanced knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes Ability to work independently with little oversight.

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