Professional Fee Coder/Auditor

Professional Fee Coder/Auditor, Revenue Cycle 

This position is responsible for Coding and Auditing Professional Fee records to determine the appropriate designation of diagnosis and procedure codes while maintaining compliance with Official Coding Guidelines.  The Coding Auditor is responsible for preparing the claim prior to claim submission which includes but is not limited to:  validation of patient demographics, insurance and carrier assignment, financial class and other pertinent data fields to ensure the claim is attached to the correct Provider Billing Group classification.  During the coding/auditing process, the Profee Coder/Auditor may indicate a provider inquiry or feedback needed and will compose physician-friendly verbiage following prescribed workflow. The ideal candidate in this role will have excellent written and/or verbal communication, analytical skills and demonstrate ability to think critically and operate autonomously in a remote environment. 

Essential Functions 

• Analyze, evaluate, and review medical records to ensure accuracy of code assignment. 
• Code Professional Fee charts and/or validate clinical code assignment (as needed per market).
• Expertise in coding or auditing Renal Specialty of Professional Fee and be able to code, audit, or train accordingly  
• Prepare Physician Inquiries and/or feedback related to code validation audits or other reviews.
• Prepare daily coding logs, independently track production for review, and maintain a coding production rate of 95% or above.
• Demonstrates proficiency in coding including both ICD-10 and CPT while maintaining 95% accuracy or above.
• Conduct claim editing activities, troubleshooting problem accounts, and conducting root cause analysis, following escalation pathway to RCM Leadership as applicable.
• Follow and adhere to AHIMA's Standards of Ethical Coding, all applicable regulations and guidelines, and all client-specific policies.
• Basic knowledge and experience in Microsoft Office applications (Excel, Office, Word, etc)
• Other duties as assigned  

Minimum Qualifications 

• Associates Degree in Health Information Management with RHIT credential; or active Coding Credential from AHIMA or AAPC coupled with years' experience. 
• 3+ years' service in a Revenue Cycle Management role with significant experience in physician based (Profee) coding. 

Preferred Qualifications 

• Bachelor of Science in Health Information Management with RHIA Credential 
• Expertise in Risk Adjustment Coding 
• HCC Certified Coding Credential is a plus
• Experience in a startup, renal care or value-based care environment
• The ideal candidate in this role will have excellent written and/or verbal communication, analytical skills and demonstrate ability to think critically and operate autonomously
• Create Physician-friendly verbiage for provider feedback processes
• Proven ability to be successful in an autonomous work environment
• Skilled in all Microsoft Office Applications 

Annual Salary Range: $63,600.00-$74,800.00