Professional Fee Coder, Full-time (Remote for PA/NJ Candidates)

1. Abstract and assigns the appropriate ICD10, HCPCS/CPT codes for all diagnosis and procedure Professional Fee services performed in outpatient and inpatient settings while following CMS guidelines. Utilizes 3M encoder for validation of RVUs and CPT procedure bundling.

2. Responsible for maintaining up-to-date knowledge of coding guidelines as they relate to physician services for hospital inpatient, observation, consultant, surgical, critical care, and E & M services.

3. Maintains an average 2 day lag in assigned coding charge review WQ.

4. Maintains a 95% coding accuracy rate as measured through quality reviews.

5. Meet production standard expectations as set by the department.

6. Resolve medical record documentation deficiencies through healthcare provider query, and provide routine feedback to healthcare providers to correct deficiencies.

7. Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being captured. Timely notification to education team to review documentation trends impacting revenue.

8. Exercises good judgement in escalating identified coding trends that may negatively impact productivity, quality or revenue to mitigate claim denials. Maximize opportunities to enhance front end, coding-related claim edits to facilitate first pass resolution.

9. Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding for all of the assigned services.

10. Maintains confidentiality of all materials handled within the Network/Entity as well as the proper release of information.

11. Complies with Network and departmental policies regarding issues of employee, patient and environmental safety and follows appropriate reporting requirements.

OTHER FUNCTIONS:

1. Responsible for monthly accountability report

2. Assists in training of new personnel.

3. Other related duties as assigned.

PHYSICAL AND SENSORY REQUIREMENTS: Sitting for up to seven hours per day, three- four at a time. Frequently uses fingers for typing, data entry, etc. Frequent use of hands. Use of upper extremities to rarely lift up to ten pounds. Rarely stoops, bends, or reaches above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general vision, near vision, peripheral vision and visual monotony.

POTENTIAL ON-THE-JOB RISKS: None identified.

Identified Risks, None Identified and/or Fit Tested Statement Which States That:

Employees who work in patient care areas where they may have potential exposure to patients with suspected or proven tuberculosis (TB) must have the ability to wear a particulate respirator and be fit-tested in compliance with the current recommendations from the CDC (enforced by OSHA) or must provide physician documentation as to the inability to wear a particulate respirator.

SPECIFIC PROTECTIVE EQUIPMENT AVAILABLE:

MOST COMPLEX DUTY: Ability to code physician/patient encounters by appropriately assigning diagnosis and procedure codes for accurate reimbursement. Knowledge of coding guidelines and Third Party documentation requirements. Understanding of E & M codes, surgical/procedure codes and requirements for coding. Ability to utilize multiple hospital programs simultaneously to complete assignments. Also, the ability to deal with providers and office staff in a tactful, but decisive manner.

SUPERVISION (RECEIVED BY AND/OR GIVEN TO): Reports to Manager of Physician Coding Service. Supervision as required.

COMMUNICATIONS: Must communicate frequently with physicians/AP’s and office staff in a tactful, diplomatic, and decisive manner.

ADDITIONAL REQUIREMENTS: Adheres to the confidentiality guidelines as outlined within the Hospital and departmental policies. Promotes positive customer satisfaction by way of prompt and courteous service.

QUALIFICATIONS

(MINIMUM)

EDUCATION: RHIA, RHIT, CPC, OR CCS-P with working knowledge of ICD-9/ICD-10, CPT and HCPCS coding required.

TRAINING AND EXPERIENCE: Minimum 1-3 years experience in CPT/HCPCS physician procedural coding. Previous experience with computerized patient record and coding system preferred.

WORK SCHEDULE: Monday-Friday, flexible hours, Occasional overtime as needed to complete assignments or projects. 100% Remote for local (PA, NJ) candidates.