certified procedural coder

Trinity Health

Employment Type: 
Full time
 
Shift: 
Day Shift
 
Description: 
Highlights: 
<ul>
<li>Full-time role in a fast-paced professional central billing environment.</li>
<li>Remote position</li>
</ul>
The Professional Office coder will review all assigned charge review errors and claim edits, ensuring correct charge capture and coding with proper ICD-10,CPT, HCPCS codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing data entry to capture charges not submitted by provider. and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders innew specialties.
 
Minimum qualifications: 
<ul>
<li>CPC, CPC-A , CCS, or CCS-P Certified</li>
<li>One to three years of experience in a medical office coding setting</li>
</ul>
What the professional office coder will do: 
<ul>
<li>Reviews encounter forms or EHR for completion and accuracy, including ICD-10, ICD9CM, CPT and HCPCS modifier assignment.</li>
<li>Understands Nextgen EHR for charge passing position, reviews chart for missing items. Uses tasking for missing information.</li>
<li>Researches all information needed to complete billing process.</li>
<li>Reads and understands operative reports and other medical records, assigns codes from review of these records procedures from notes.</li>
<li>Performs accurate data entry from encounter form.</li>
<li>Performs claim correction process and properly submits per payer request.</li>
<li>Follows daily, weekly& monthly audit reports - charge review, edits, missing charges.</li>
<li>Resolves coding discrepancies related to coding and revenue capture.</li>
</ul>
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.

Professional Office Coder

CODING SPECIALIST - Medical Group -  Remote

Palm Medical Centers

<div>At Palm Primary Care (PPC) our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of.
With more than 24,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve.
Every day, we deliver on our promise to bring value based, quality healthcare to our patients. 
Overview
PPC is looking for a CDI/Certified Professional Coder who will demonstrate deep knowledge in Medical Risk Adjustment, HEDIS, CNS Coding guidelines, billing standards and regulations. A teamwork person who will deliver a high standard of quality of work to drive improved business performance.
Duties and Responsibilities<ul><li>
Conduct workflows in Coding and Quality processes, medical record completion and department projects for accuracy in medical record documentation as needed.</li><li>
Ensures proper code selection for compliance with ICD-10-CM Official Guidelines for Coding and Reporting.</li><li>
Educates physicians on proper documentation and compliance standards.</li><li>
Reviews medical record to include consultations (inpatient and outpatient) and hospital discharge summaries to ensure continuity of care and continued coding for accurate risk adjustment.</li><li>
Performs pre-post audits to ensure medical record completeness, consistency, and compliance.</li><li>
Works collaboratively with medical and supporting staff to follow-up on documentation needs to support the diagnosis and quality measures based on patient age and chronic conditions.</li><li>
Uses only pre-approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure.</li><li>
Develops and maintains professional skills and knowledge through training programs including education sessions for ICD-10-CM and CPT codes.</li><li>
Demonstrates a thorough understanding of Coding Guidelines.</li><li>
Demonstrates understanding of company policies which impact Coding functions and takes ownership for compliance for own area of responsibility.</li><li>
Collaborates with Supervisor as necessary to clarify and verify information. Reports opportunities identified in concurrent and retrospective clinical documentation to support quality, regulatory compliance, and effective coding.</li><li>
Participates in department meetings. Consistently demonstrates awareness and willingness to fulfill Service Excellence Commitments.</li><li>
Works collaboratively with team members, other departments, and clinical staff consistent with the Mission and Vision of the company.</li><li>
Willingly performs similar or related tasks as assigned.</li><li>
Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary.</li><li>
Reports any issues to Quality, Compliance and Operations as necessary.</li><li>
Accurately enters all identified and validated procedures codes in claims into the practice&rsquo;s EMR.</li><li>
Assists in all RAPS submission projects as they occur if needed.</li><li>
Performs all other coding and documentation reviews and/or projects as asked and assists/coordinates strategies as defined by the department head or assistant.</li></ul>
Education and Experience:<ul><li>
Certified Professional Coder (CPC) through AAPC or AHIMA.</li><li>
2 years of experience as Certified Professional Coder at minimum.</li><li>
Proficient in assigning ICD-10-CM codes according to provider documentation level to comply with federal regulations and insurance requirements.</li><li>
Computer skills, Word, Excel, HER.</li><li>
Ability to travel to medical centers if needed and/or work remotely.</li><li>
Foreign graduate, nurse, or some Medical background is a plus.</li></ul>
Required Skills/Abilities:<ul><li>
Excellent verbal and written communication skills.</li><li>
Excellent customer service skills.</li><li>
Excellent organizational skills and attention to detail.</li><li>
Ability to effectively present information in one-on-one situations to providers, office staff, insurance companies, and other employees.</li><li>
To perform this job successfully, an individual must have knowledge of Microsoft Word, Excel, Internet software, Email software, and insurance web sites.</li><li>
Strong sense of business ethics.</li><li>
Ability to follow company policies and procedures.</li></ul>
Physical Requirements:<ul><li>
Prolonged periods of sitting at a desk and working on a computer.</li><li>
While performing the duties of this job the employee is regularly required to sit, use hands and arms, talk and hear.</li><li>
Must be able to lift up to 10 pounds at times.</li></ul>
Benefits:<ul><li>
Health insurance</li><li>
Dental Insurance</li><li>
Vision insurance</li><li>
Life insurance</li><li>
401(k)</li><li>
Paid time off</li></ul>
Schedule:<ul><li>
8 hour shift</li><li>
Day shift</li><li>
Monday to Friday</li></ul>
Job Type: Remote / Full-time 
 
Palm Primary Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. 
 
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Primary Care makes hiring decisions based solely on qualifications, merit, and business needs at the time.
Vm1Iqy531h</div>

Clinical Documentation Improvement/Certified Professional Coder

Advantia health

<div>Advantia is seeking a Certified Professional Coder to join our team! The ideal candidate will have a strong background in medical coding, attention to detail, and the ability to lead and mentor a team of Medical Billers. This role is critical in ensuring accurate and efficient coding practices, compliance with regulatory standards, and optimizing revenue cycle processes. The ideal candidate for this role will have subspeciality experience in obstetrics, gynecology, lab billing, genetic testing, cancer screening, and mammography.
Job Responsibilities:
 <ul><li>Review Medical Records to identify diagnoses/procedures.</li><li>
Perform accurate and timely coding of medical records using ICD-10-CM, CPT, and HCPCS codes.</li><li>
Ensure compliance with federal and state regulations, payer guidelines, including Medicare and Medicaid guidelines and company policies.</li><li>
Act as a liaison between the coding team and other departments, such as billing, compliance.</li><li>
Work closely with OBGYN physicians, advanced practice providers, nurses, and administrative staff to ensure accurate coding and billing.</li><li>
Track and request outstanding claims for assigned departments / facilities.</li><li>
Implement best practices and innovative solutions to enhance coding operations.</li></ul>
Qualifications:
<ul><li>High School/GED Education required</li><li>
Prior experience in lab billing, genetic testing, cancer screening, and mammography is preferred.</li><li>
This position requires certification as a Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).</li><li>
CPC-P or CPC certification is required (AAPC)</li><li>
Certification in OBGYN coding (COBGC) preferred.</li><li>
Minimum of 2 years of medical coding experience, with a focus on OBGYN coding.</li><li>
In-depth knowledge of ICD-10-CM, CPT, HCPCS coding systems, and medical terminology.</li><li>
Proficiency in electronic health records and billing software preferred.</li></ul>
Benefits &amp; Compensation: 
<ul><li>Health, Dental, and Vision Insurance</li><li>
Health Savings Account (HSA) and Flexible Savings Account (FSA) Option</li><li>
401k Retirement Plan</li><li>
Life and Disability Insurances</li><li>
Paid holidays/PTO</li></ul>
Please note: Advantia Health is dedicated to providing unparalleled healthcare to our customers by employing the most highly-qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment.
Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.</div>

Certified Professional Coder

Sanford Health

Careers With Purpose 
 
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. 
 
Facility: Remote MN
 
Location: Remote, MN
 
Address:
 
Shift: 8 Hours - Day Shifts
 
Job Schedule: Full time
 
Weekly Hours: 40.00
 
Salary Range: $19.00 - $30.50 
 
Department Details 
 
Our Coders review medical documentation, assign appropriate codes (ICD-10, HCPCS, CPT), and ensure compliance with coding standards, regulations, and company procedures. 
 
The position requires strong problem-solving skills, effective communication with medical professionals to improve documentation accuracy and the ability to work independently, 
 
We offer flexible hours and the ability to work remotely. 
 
Pay starts at $19.00/hr with additional credit given for work experience relative to this role. 
 
Job Summary 
 
Serve as a resource for providers in understanding covered indications and the supporting documentation. Supports both technical and professional services in provider clinic as well as Ambulatory Surgery Centers (ASC) and in addition hospital professional services. Maintains a thorough understanding of National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Understands and supports the Medicare and Commercial Carrier workflows related to daily coding and denial review and appeals management, including the preparation of supporting documents and information to support the appeal process. Monitors and validates physician charge capture. 
 
Self-motivated with the ability to work independently, multi-task, problem solve and make informed and accurate recommendations to medical professionals based on current information. Participates in coding team meetings and serves as a subject matter expert. 
 
Reviews medical documentation from physicians and other healthcare providers; assigns modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards. Uses relevant policies, procedures, and individual judgment to determine whether events or processes comply with laws, regulations, or standards. 
 
Provide accurate and timely international classification of disease &ndash; tenth edition &ndash; clinical modification (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) coding, and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures. 
 
Review and audit medical record documentation accurately to reflect healthcare coding and to substantiate appropriate service reimbursement. Conveying coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation. 
 
Computer skills, the ability to interpret, analyze and abstract data/documentation, have good problem-solving skills, be self-motivated and have good time management and organizational skills. 
 
Qualifications 
 
Associate degree in Health Information Technology or Certification in Coding required. 
 
Specific knowledge of diagnostic and procedural terminology, successful coursework from an accredited institution in International Statistical Classification of Diseases (ICD) diagnosis, Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) coding schemes, medical terminology or human anatomy/physiology is preferred. 
 
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Professional Coder-Apprentice (CPC-A), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician based (CCS-P), CCS Healthcare (CCS-H), Certified Outpatient Coder (COC) required. If the associate is not certified at hire, the associate must be so within one year of the date of hire. 
 
Benefits 
 
Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits . 
 
Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org . 
 
Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment. 
 
Req Number: R-0254168
 
Job Function: Revenue Cycle
 
Featured: No

Coder, Provider Practice - Cardio and Vascular

HonorHealth

<div>Overview: Looking to be part of something more meaningful? At HonorHealth, you&rsquo;ll be part of a team, creating a multi-dimensional care experience for our patients. You&rsquo;ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact. HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more. Join us. Let&rsquo;s go beyond expectations and transform healthcare together. HonorHealth is one of Arizona&rsquo;s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 17,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com. Responsibilities: Job Summary 
Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT and HCPCS codes through review of inpatient or outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. 
Essential Functions 
<ul><li>
Inpatient: Assigns and sequences ICD-10-CM and ICD-10-PCS diagnostic and procedural codes for inpatient accounts within HonorHealth. Reviews physician documentation &amp; coding for appropriateness &amp; accuracy and makes corrections following Medicare &amp; AMA coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses applicable coding edits. Assigns DRGs as applicable. Outpatient: Assigns and sequences ICD-10-CM, CPT and HCPCs diagnostic and procedural codes for outpatient accounts within HonorHealth. Reviews physician documentation &amp; coding for appropriateness &amp; accuracy and makes corrections following Medicare &amp; AMA coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses NCCI, OCE, LCD, and other applicable coding edits.</li><li>
Inpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD code selection. Outpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD and CPT code selection.</li><li>
Inpatient/Outpatient: Communicates and assists in education with an audience that may include physicians and clinical staff.</li><li>
Inpatient: Assists Patient Financial Services with interpretation and selection of appropriate ICD codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters. Outpatient: Assists Patient Financial Services with interpretation and selection of appropriate ICD, CPT, and HCPCs codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters.</li><li>
Inpatient/Outpatient: Performs outpatient charge validation/reconciliation for outpatient coding to ensure all submitted charges are posted timely and balance with total submitted charges. Assigns charges as applicable.</li><li>
Inpatient/Outpatient: Resolves routine coding issues/problems and appropriately seeks assistance from supervisor.</li><li>
Performs other duties as assigned.</li></ul>
Education 
<ul><li>
Associate's Degree in health related field - Preferred</li><li>
High School Diploma or GED - Required</li></ul>
Experience 
<ul><li>
2 years Inpatient: Hospital inpatient coding. Outpatient: Coding outpatient accounts which may include Emergency department, newborn, obstetrics, day surgery, observation, wound care, radiology, laboratory, series, infusion, oncology, and rehab therapy. - Preferred</li><li>
Other Inpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM and ICD-10-PCS codes. Outpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM, CPT, and HCPCs codes. - Required</li><li>
Other Inpatient: Knowledge of pathology, pharmacology, microbiology, radiology, and other clinical specialties. Outpatient: Working knowledge of charging and billing processes. Working knowledge of Medicare, NCCI, OCE, LCD, NCD, and other claim edit guidelines and protocol. - Preferred</li></ul>
Licenses and Certifications 
<ul><li>
CCA (Certified Coding Apprentice) with successful certification of CCS in 6 months OR Inpatient: CCS (Certified Coding Specialist), or CIC (Certified Inpatient Coder), or RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) Outpatient: CPC-H (Certified Professional Coder-Hospital Outpatient), or CPC (Certified Professional Coder), or COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist), or RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) - Required</li><li>
CCS, CPC-H/COC, CIC, RHIT, or RHIA - Preferred</li></ul>
Facility: HonorHealth Support Services Department: Coding Work Hours: Mon-Fri 40 hrs/week. 8am - 4:30 pm Hours flexible. Shift: Day Position Type: Full-Time</div>

Coder 1 Outpatient

Pride Health

<div>
 
 
 Certified Medical Coders
 
 
 
 
 
 
 
 Work Arrangement:
 
 
 <ul>
 <li>
 Full-time | 40 hours per week | Monday&ndash;Friday
 </li>
 <li>
 EPIC &amp; 3M experience required
 </li>
 <li>
 CCS and CPC certification required
 </li>
 </ul>
 
 
 
 
 
 Position Summary
 
 
 
 The Certified Medical Coder is responsible for accurately and compliantly assigning diagnostic and procedural codes for services provided in an acute care setting. Open positions include
 
 outpatient
 
 and
 
 emergency department (ED)
 
 coding, as
 
 well as inpatient
 
 coding. Candidates must demonstrate strong technical skills, regulatory knowledge, and proficiency with EPIC and 3M applications.
 
 
 
 
 
 
 Essential Duties (Both Roles)
 
 
 <ul>
 <li>
 Perform coding using ICD-10, CPT-4, and encoder tools in alignment with industry guidelines
 </li>
 <li>
 Ensure all coding complies with federal, payer, and regulatory standards
 </li>
 <li>
 Review clinical documentation to assign correct diagnoses and procedure codes
 </li>
 <li>
 Utilize EPIC, 3M/HDS, Microsoft Office, and other coding software
 </li>
 <li>
 Maintain knowledge of anatomy, physiology, and disease processes
 </li>
 <li>
 Research and resolve coding-related issues
 </li>
 <li>
 Support coder education/training processes as needed
 </li>
 <li>
 Collaborate with clinical and revenue cycle teams to promote accuracy
 </li>
 </ul>
 
 
 
 
 
 Requirements
 
 
 
 
 
 
 
 General Requirements (Applies to Both Roles)
 
 
 <ul>
 <li>
 Minimum
 
 3 years of acute care medical coding experience
 
 </li>
 <li>
 Strong knowledge of
 
 ICD-10, CPT-4
 
 , and encoder tools
 </li>
 <li>
 Experience using
 
 EPIC
 
 and
 
 3M/HDS
 
 </li>
 <li>
 Understanding of anatomy, physiology, disease processes, payer rules, and coding guidelines
 </li>
 <li>
 Ability to analyze medical documentation for accurate code selection
 </li>
 <li>
 High School Diploma/GED required
 </li>
 </ul>
 
 
 
 
 
 Outpatient &amp; ED Coding &ndash; Role-Specific Requirements
 
 
 <ul>
 <li>
 Experience coding
 
 Outpatient
 
 services and
 
 Emergency Department (ED)
 
 encounters
 </li>
 <li>
 Proficiency in outpatient billing, CPT coding, same-day procedures, and ancillary services
 </li>
 <li>
 Accepted certifications:
 </li>
 <li>
 
 CCS &ndash; Required
 
 </li>
 <li>
 
 CPC &ndash; Accepted (Outpatient/ED only)
 
 </li>
 <li>
 RHIA, RHIT, CCP &ndash; Accepted but CCS/CPC preferred
 </li>
 </ul>
 
 
 
 
 
 Inpatient Coding &ndash; Role-Specific Requirements
 
 
 <ul>
 <li>
 Experience coding
 
 acute Inpatient
 
 hospital records
 </li>
 <li>
 Understanding of:
 </li>
 <li>
 
 MS-DRG / APR-DRG methodologies
 
 </li>
 <li>
 Inpatient-specific documentation and billing requirements
 </li>
 </ul>
 
 
 
 
 
 Education &amp; Certifications
 
 
 <ul>
 <li>
 High School Diploma or GED required
 </li>
 <li>
 Acceptable certifications based on role:
 </li>
 <li>
 CCS or CPC certification required
 </li>
 <li>
 RHIA, RHIT, CCP (accepted)
 </li>
 </ul>
 
 
 
 
 Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
 
 
 
</div>

Medical Coder

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