physician coding specialist

Covenant Health

<div>Overview:<div></div><div> 
Coding Specialist, Centralized Coding, Outpatient</div><div>
Full Time, 80 Hours Per Pay Period, Day Shifts</div><div></div><div> 
Covenant Health Overview:</div><div>
Covenant Health is the region&rsquo;s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area&rsquo;s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area&rsquo;s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes &ldquo;Best Employer&rdquo; seven times.</div><div></div><div> 
Position Summary:</div><div>
This individual provides leadership, direction, and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as the user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record documentation and coding accuracy, developing and updating all departmental policies and procedures relative to coding, performing quality reviews of coding/abstracting, and focusing on problem solving issues related to denials. Provides assurance that billing practices are complete, accurate, and in compliance with state and federal guidelines.</div>
Responsibilities:
<ul><li>Oversees through monitoring and by reviewing and auditing the coding staff to ensure position accountabilities and performance criteria are adhered to.</li><li>
Develops and maintains departmental and hospital policies and procedures and implements new policies and procedures relative to coding.</li><li>
Educates and assists physicians and clarifies coding versus clinical issues.</li><li>
Works closely with Registration and Business Office personnel to resolve issues related to claims, coding, pre-cert, and denials appeals, and verifies that appropriate chargemaster rates are used.</li><li>
Reviews medical record documentation to ensure existing documentation supports diagnostic/procedure code billed per UB 92 or HCFA 1500 form.</li><li>
Provides education to coding staff and physicians in response to regulatory changes and identified areas of deficiency.</li><li>
Monitors claim rejections and systematically assesses specific types of denial as it relates to coding and documentation issues, outpatient registration, and the receipt of physician orders.</li><li>
Attends meetings and provides input as it relates to coding, medical documentation, and reimbursement issues specific to medical billing and regulatory requirements.</li><li>
Increases awareness of compliance as it relates to coding and documentation.</li><li>
Facilitates and coordinates education of coding staff in the areas of coding, documentation, case mix, and denials.</li><li>
Increases understanding of APCs, DRGs, case mix, and denials.</li><li>
Educates coding staff to proper documentation necessary to support a DRG/APC/Medical Necessity/ROM/SOI.</li><li>
13 Integrates documentation, coding, and proper oversight to ensure accurate reimbursement.</li><li>
Reviews records to verify if the correct code has been assigned.</li><li>
Assists with all insurance requested audits and provides information to supervisor related to inaccurate and/or missing documentation.</li><li>
Reviews DRG/APC classifications and educates to maximize level of care assignment for increased reimbursement.</li><li>
Keeps current on local, state, and federal regulations to ensure compliance.</li><li>
Keeps current on coding guidelines and communicates to Health Information Manager. Implements corrective actions as indicated to minimize financial risk.</li><li>
Works with Denials Elimination Group and deals with physician specific issues as it impacts denials.</li><li>
Ensures LCDs/NCDs are being adhered to by admissions and hospital personnel to ensure qualifying diagnosis covers tests/procedures.</li><li>
Analyzes denials and coordinates appeals.</li><li>
Ensures corrective action is taken to prevent denials from reoccurring.</li><li>
Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.</li><li>
Performs other duties as assigned.</li></ul>
Qualifications:
<div>
Minimum Education:
</div><div>None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.</div><div></div><div> 
Minimum Experience:
</div><div>Five or more (5+) years coding experience.</div><div></div><div> 
Licensure Requirement:
</div>RHIA, Coding, or RHIT certification required. Registered Health Information Technologist preferred.</div>

CODING SPEC-CLINIC

<div>
 
 
 WHO WE ARE:
 
 
 
 
 AC3 was founded by a group of oncologists who built solutions to optimize their own practices. Now, we give specialty health practices the power to make decisions with better data. Our mission is to help them thrive through people, purposeful technology, and collaboration. The work we do empowers healthcare practitioners and their teams to provide the highest quality of care in a sustainable way.&nbsp;That&rsquo;s&nbsp;what motivates&nbsp;us.
 
 
 
 We&rsquo;re looking for passionate, driven innovators to join our mission. If you thrive on challenge, love taking action, and get up every day ready to make a difference, apply now. Learn more at www.ac3health.com.&nbsp;
 
 
 
 
 COMPANY MISSION:&nbsp;
 
 
 
 To help specialty practices thrive.
 
 
 
 &nbsp;
 
 POSITION SUMMARY:&nbsp;
 
 The Certified Medical Coder is responsible for ensuring all diagnoses and procedures are coded appropriately for all claims. This position will need to remain current on coding and billing regulations as well as any CPT, ICD10 or HCPCS updates. This role supports the department to design the capture of associated coding and billing various medical specialties. They will work cooperatively as a team with revenue cycle, client practices and management associates. He/she will provide courteous and professional assistance with coding questions from physicians, clinical team members and other departments. The successful candidate for this role must have exceptional computer, communication, and organizational skills. This position may require onsite training at our office in South Bend, IN, as well as attendance of department and organizational meetings.&nbsp;
 
 
 
 
 ESSENTIAL FUNCTIONS AND JOB RESPONSIBILITIES
 
 
 
 
 Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 
 
 <ul>
 
 <li>
 Responsible for billing daily charges by designated site and matching insurance carriers to the specific billing requirements for Medicare, Medicaid, Blue Cross Blue Shield and Commercial carriers.
 </li>
 
 <li>
 Capable and knowledgeable on billing charges for chemotherapy and administration codes, E/M office and hospital charges in a timely manner.
 </li>
 
 <li>
 Accessing and reading operative and pathology reports from multiple hospital systems, coding the correct ICD-10, CPT, and modifiers, and billing the charges.
 </li>
 
 <li>
 Retrieves, reads, and applies updated LCD/NCD policies when necessary.
 </li>
 
 <li>
 Identifies and reports any fraud, waste, or abuse concerns.
 </li>
 
 <li>
 Reviews patients&rsquo; charts and applies appropriate medical codes.
 </li>
 
 <li>
 Works with the clients&rsquo; physician team to get any missing information or signatures to bill charges.
 </li>
 
 <li>
 Ensures timely filing of claims per SOP guides.
 </li>
 
 <li>
 Works together as a team with the whole department.
 </li>
 
 <li>
 Maintains the practices and principles set forth by AC3 leadership with a strong commitment to service, excellence and quality.
 </li>
 
 <li>
 Maintains professional behavior, confidentiality, and discretion at all times, along with the ability to work with all levels of staff with a confident and professional demeanor.
 </li>
 
 <li>
 Follows HIPPA rules and regulations.
 </li>
 
 </ul>
 
 
 
 &nbsp;
 
 
 POSITION REQUIREMENTS
 
 
 
 <ul>
 
 <li>
 High school diploma or equivalent (GED). &nbsp;One or more of the following credentials is required: CPC (Certified Professional Coder); CHONC (Certified Hematology Oncology Coder, through AAPC); CCS (Certified Coding Specialist, through AHIMA); or CCS-P (Certified Coding Specialist &ndash; Physician based, through AHIMA).
 </li>
 
 <li>
 Demonstrates knowledge and competence in CPT, ICD-10, POS and modifiers.
 </li>
 
 <li>
 Accurately maintains and adheres to all safety rules and regulations.
 </li>
 
 <li>
 Accurately code/bill charges to the best of your ability without fraudulence.&nbsp;
 </li>
 
 <li>
 Knowledge of anatomy and medical terminology.
 </li>
 
 <li>
 Proficient in Microsoft Office preferred. &nbsp;Working knowledge/experience in electronic medical records and/ or other medical software if applicable.
 </li>
 
 <li>
 Excellent communication and organizational skills with the ability to work in a fast paced environment; prioritize tasks and workloads.
 </li>
 
 <li>
 Performs other duties as assigned.
 </li>
 
 <li>
 This is a remote position with the expectation of travel to meet the needs of the position. Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. &nbsp;Must be able to operate standard office equipment and keyboards.&nbsp;
 </li>
 
 </ul>
 
 
 
 WORK LOCATION:
 
 
 &nbsp;This is a hybrid position; meaning, there will be required onsite training and a combination of a remote and onsite work. The ideal candidate will reside within a 30-mile radius of the office located in South Bend, IN.
 
 
 
 
 Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. &nbsp;Must be able to operate standard office equipment and keyboards.&nbsp;
 
 
 
 
 Why Work at AC3?
 
 
 
 
 When you become an AC3 Team member, you can expect ongoing training, support, and a work culture like no other. We offer our Full-Time Team Members medical, dental and vision health and wellness benefits, along with employer paid life insurance, long and short-term disability policies. &nbsp;Because our team&rsquo;s health and wellness are our priority, we start new hires off with an above average paid time out plan and offer a comprehensive wellness program, including onsite biometrics and ongoing mental and physical wellness support. We also provide all Team Members with access to company sponsored financial wellness counselors, employee assistance services and the opportunity to enroll in our company-matched, 401k plan.
 
 
 
 
 Come join our Winning Team!
 
 
</div>

Medical Coding Specialist - Hybrid

ECU Health

<div>Position Summary
Reviews medical record documentation, extracts data, and applies appropriate diagnosis and procedure codes for complex multi-specialty physician group. Coding responsibilities include inpatient hospital, outpatient hospital, and ambulatory services to support professional fee billing, internal and external reporting, research and regulatory compliance. Complies with the ICD-10-CM and CPT/HCPCS Official Guidelines for coding and reporting as well as other nationally established rules and regulations for coding assignment.
Responsibilities
<ul><li>Provides code assignment for all levels of Professional Fee (Physician Coding) for Inpatient, Outpatient and/or Ambulatory Services and/or Charge Entry services for large multi-specialty physician group.</li><li>
Assigns diagnostic and procedural codes to patient records using ICD-10-CM and CPT/HCPCS and any other designated coding classification systems in accordance with coding guidelines.</li><li>
Assigns and sequences codes accurately based on medical record documentation.</li><li>
Verifies accuracy of code assignment provided by physicians and/or designated staff.</li><li>
Assigns diagnosis/procedure codes utilizing the 3M Encoder to arrive at the most accurate code within designated time frame as agreed upon and/or outlined in policy.</li><li>
Incorporates current regulatory coding requirements and guidelines appropriately.</li><li>
Maintains weekly coding productivity log and provides feedback to the Supervisor/Manager of VMG Coding regarding any coding 
issues/problems.</li><li>
Maintains coding accuracy of 90% or better, in accordance with Medical Group policy.</li><li>
Average number of records coded per hour must meet minimum established quantitative standards per type of patient record.</li><li>
Responsible for reviewing claims and correcting Claims Manager and/or Epic edits.</li><li>
Demonstrates effective computer skills for all coding functions.</li><li>
Maintains confidentiality of patient information.</li><li>
Participates in In-Service education, updates and conferences to remain current with coding requirements and 
guidelines.</li><li>
Maintains AHIMA and/or AAPC credentials.</li></ul>
Minimum Requirements
<ul><li>High School or Equivalent (GED) and one of the following AHIMA or AAPC credentials is required: RHIA, RHIT, CCS, CCS-P, CPC<ul><li>
Associate's Degree in Health Information Technology or Bachelor's Degree in Health Information Management is preferred.</li></ul></li><li>
1 - 2 years relevant coding experience required.</li></ul>
Pay Range
$23.52 - $34.28
Other Information
<ul><li>Remote role (based out of Greenville, NC)</li><li>
Monday - Friday day shift</li><li>
Great Benefits</li></ul>
#LI-REMOTE
#LI-AH2
ECU Health
About ECU Health
ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.
The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Childrens Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicants qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.</div>

Coding Specialist II - Physician Group (Surgery Team)

ExamWorks

<div>
 
 Exam Works is looking for a Medical Coding Specialist to join our team remotely!
 
 
 
 <ul>
 <li>
 Must possess current coding certification in CPC. CPMA certification &amp; Certified Life Care Planner certification preferred.
 
 
 </li>
 </ul>
 The
 
 Medical Coding Specialist
 
 (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates.
 
 
 Schedule for this role is:
 
 Monday - Friday 8am-5pm EST
 
 
 
 
 Essential Job Functions
 
 
 
 <ul>
 <li>
 Receive and input client and examinee data in the system database.
 </li>
 <li>
 Sort and verify each claim.
 </li>
 <li>
 Process and review each claim and address all necessary modifications manually. Contact Client as needed
 </li>
 <li>
 Perform quality assurance on every case prior to completion.
 </li>
 <li>
 Ensure all medical records and reports are properly documented and saved in the appropriate location and available for audit at all times.
 </li>
 <li>
 Process client invoicing in accordance with the client&rsquo;s fee schedule.
 </li>
 <li>
 Handle and responds promptly to incoming calls, emails or faxes from clients requesting report status and/or information.
 </li>
 <li>
 Provide notification to the Supervisor of any provider appeals and follow directions as given to resolve the claim.
 </li>
 <li>
 Provide testimony in court as to the content of prepared reports, as required. Travel as necessary.
 </li>
 <li>
 Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations.
 </li>
 <li>
 Perform quality assurance on various coding related reviews.
 </li>
 <li>
 Perform other duties as assigned.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 
 Education and/or Experience
 
 
 
 <ul>
 <li>
 High school diploma or equivalent required.
 </li>
 <li>
 Minimum one year medical billing experience; or equivalent combination of education and experience required.
 
 
 </li>
 </ul>
 
 Certificates, Licenses, Registrations
 
 
 
 
 Must Possess Current Coding Certification In
 
 
 
 <ul>
 <li>
 OASIS, RAC-CT, CCS, CPC, RHIT or RHIA. CPMA certification preferred.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Must have minimum of one year medical billing experience; or equivalent combination of education and experience required.
 </li>
 <li>
 Must have a full understanding of aspects of medical billing.
 </li>
 <li>
 Must demonstrate understanding of the various types of medical billings and ability to identify which system database should be used.
 </li>
 <li>
 Must be able to cross reference different types of billings to ensure consistency in the review process.
 </li>
 <li>
 Must possess knowledge of standard fee schedule review, UC&amp;R review, drug and supply charges, rarity, utilization review, CPT guidelines, ICD 10, bundling/unbundling, duplicate billing and CMS reimbursement guidelines.
 </li>
 <li>
 Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
 </li>
 <li>
 Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
 </li>
 <li>
 Must have a full understanding of HIPAA regulations and compliance.
 </li>
 <li>
 Must be a qualified typist with a minimum of 35 W.P.M.
 </li>
 <li>
 Ability to follow instructions and respond to managements&rsquo; directions accurately.
 </li>
 <li>
 Ability to work independently, prioritize work activities and use time efficiently.
 </li>
 <li>
 Must be able to maintain confidentiality.
 </li>
 <li>
 Must be able to demonstrate and promote a positive team -oriented environment.
 </li>
 <li>
 Must be able to stay focused and concentrate under normal or heavy distractions.
 </li>
 <li>
 Must be able to work well under pressure and or stressful conditions.
 </li>
 <li>
 Must possess the ability to manage change, delays, or unexpected events appropriately.
 </li>
 <li>
 Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
 
 
 </li>
 </ul>
 
 ExamWorks
 
 is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
 
 
 
 ExamWorks, LLC
 
 is 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, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
 
 
 
 Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
 
 
 
 
 
 ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
 
 
 
 
 TAGS
 
 
 CPC, CPMA, Medical Billing, Medical Billing Specialist
</div>

Medical Coding Specialist (31620)

Mercyhealth

<div>Essential Duties and Responsibilities 
<ul><li>
Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.</li><li>
Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.
</li><li>Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.</li><li>
Researches any coding inquiries the provider or medical staff may have, and presents findings to them.</li><li>
Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.</li><li>
Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare &amp; Medicaid Services (CMS) and contracted payers.</li><li>
Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.</li><li>
Works with billing partners in developing efficient coding processes and researching denials.</li><li>
Responds to customer concerns through coding reviews requested by other departments.</li><li>
Conducts provider coding orientation and education sessions and documents all information presented.</li><li>
Maintains an in-depth knowledge of Epic ambulatory and hospital modules.</li><li>
Works as a team to achieve productivity goals.</li></ul> 

Culture of Excellence Behavior Expectations 
To perform the job successfully, an individual should demonstrate the following behavior expectations:
 
 
Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals. 
 
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions. 
 
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals. 
 
Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue. 
Education and Experience 
High School graduate or equivalent 
Two years of experience coding professional services in multiple specialties 
Certification and Licensure 
Certified Professional Coder (CPC) or other equivalent coding certification required 
Skills and Abilities 
Problem solving skills 
Excellent written/oral/interpersonal/communication skills
 
Analytical skills
 
 
Special Physical Demands 
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. 
While performing the duties of this job, the partner is regularly required to talk and hear. Eyesight to identify numbers, folders, colors, and computer printouts. Speech to communicate one-on-one and over the telephone. Manual dexterity to operate keyboards, mouse and telephones. Prolonged sitting; use hands to finger, handle, or feel and reach with hands and arms. The partner is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The partner must occasionally lift and/or move up to 25 pounds. 
 
 
Level of Supervision 
N/A 
Supervises 
N/A
PAY RANGE:
$24.12 - $36.18
Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.
Mercyhealth offers competitive pay and a comprehensive benefits package including:
<ul><li>Medical, Dental, Vision</li><li>
Life &amp; Disability Insurance</li><li>
FSA/HSA Options</li><li>
Generous, accruing paid time off</li><li>
Paid Parental and caregiver leave</li><li>
Career advancement and educational opportunities</li><li>
Tuition and certification reimbursement</li><li>
Certification Reimbursement</li><li>
Well-being Programs</li><li>
Employee Discounts</li><li>
On-Demand Pay</li><li>
Financial Education</li><li>
Annual recognition/awards events</li><li>
Partner appreciation days</li><li>
Family entertainment/attractions discount</li><li>
Community service/improvement opportunities</li></ul>
Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don&rsquo;t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.
Mercyhealth has been nationally recognized for our commitment to our people and culture, including:
<ul><li>#1 in the nation on AARP's Best Employers for Workers Over 50</li><li>
One of Working Mother magazine's 100 Best Companies for Working Mothers</li><li>
A Top 50 Company and Top 10 Nonprofit for Executive Women</li></ul></div>

Medical Coding Specialist

<div>ESSENTIAL DUTIES AND RESPONSIBILITIES<ul><li>
Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.</li><li>
Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.</li><li>
Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.</li><li>
Researches any coding inquiries the provider or medical staff may have, and presents findings to them.</li><li>
Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.</li><li>
Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare &amp; Medicaid Services (CMS) and contracted payers.</li><li>
Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.</li><li>
Works with billing partners in developing efficient coding processes and researching denials.</li><li>
Responds to customer concerns through coding reviews requested by other departments.</li><li>
Conducts provider coding orientation and education sessions and documents all information presented.</li><li>
Maintains an in-depth knowledge of Epic ambulatory and hospital modules.</li><li>
Works as a team to achieve productivity goals.</li></ul>
EDUCATION AND EXPERIENCE
High School graduate or equivalent 
Two years of experience coding professional services in multiple specialties
CERTIFICATION AND LICENSURE
Certified Professional Coder (CPC) or other equivalent coding certification required 
SKILLS AND ABILITIES 
Problem solving skills 
Excellent written/oral/interpersonal/communication skills 
Analytical skills 
 
SPECIAL PHYSICAL DEMANDS
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. 
While performing the duties of this job, the partner is regularly required to talk and hear. Eyesight to identify numbers, folders, colors, and computer printouts. Speech to communicate one-on-one and over the telephone. Manual dexterity to operate keyboards, mouse and telephones. Prolonged sitting; use hands to finger, handle, or feel and reach with hands and arms. The partner is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The partner must occasionally lift and/or move up to 25 pounds.
LEVEL OF SUPERVISION
N/A
SUPERVISES
N/A
PAY RANGE:
$24.12 - $36.18
Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.
Mercyhealth offers competitive pay and a comprehensive benefits package including:
<ul><li>Medical, Dental, Vision</li><li>
Life &amp; Disability Insurance</li><li>
FSA/HSA Options</li><li>
Generous, accruing paid time off</li><li>
Paid Parental and caregiver leave</li><li>
Career advancement and educational opportunities</li><li>
Tuition and certification reimbursement</li><li>
Certification Reimbursement</li><li>
Well-being Programs</li><li>
Employee Discounts</li><li>
On-Demand Pay</li><li>
Financial Education</li><li>
Annual recognition/awards events</li><li>
Partner appreciation days</li><li>
Family entertainment/attractions discount</li><li>
Community service/improvement opportunities</li></ul>
Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don&rsquo;t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.
Mercyhealth has been nationally recognized for our commitment to our people and culture, including:
<ul><li>#1 in the nation on AARP's Best Employers for Workers Over 50</li><li>
One of Working Mother magazine's 100 Best Companies for Working Mothers</li><li>
A Top 50 Company and Top 10 Nonprofit for Executive Women</li></ul></div>

Medical Coding Specialist 2

Houston Methodist

<div>At Houston Methodist, the Sr Coding Specialist position is responsible for applying correct coding conventions to patient charge encounters in a clinical environment. This position abstracts diagnosis and procedural services from the physician record and reviews and corrects charge review and claim edit related coding errors in the electronic health record. In addition, the Sr Coding Specialist position is responsible for reviewing, correcting and appealing coding related claim denials and mentoring and cross training Coding Specialists.
<div>FLSA STATUS 
Non-exempt 
 
QUALIFICATIONS 
 
EDUCATION<ul><li>
High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
</li></ul> 
EXPERIENCE<ul><li>
Five years of professional coding experience
</li></ul> 
LICENSES AND CERTIFICATIONS 
Required<ul><li>
Must have one of the following: &bull;CCS - Certified Coding Specialist (AHIMA) &bull;CPC &ndash; Certified Professional Coder (AAPC)
</li></ul> 
SKILLS AND ABILITIES<ul><li>
Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations
</li><li>Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
</li><li>Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
</li><li>Knowledge of ICD-9, ICD-10, and CPT codes
</li><li>Working knowledge of medical terminology, anatomy, and physiology
</li><li>Proficiency with Microsoft Office applications such as Word and Excel
</li><li>Must be a self-motivated individual with the ability to think critically and work independently
</li><li>Must have the ability to multi-task in a fast paced rapidly changing healthcare environment
</li><li>Demonstrates a high level of professionalism, customer service, and interpersonal skills and operates under strict confidentiality guidelines
</li>Strong training, leadership, and mentoring skills 
<li>
</li></ul> 
 
ESSENTIAL FUNCTIONS 
 
PEOPLE ESSENTIAL FUNCTIONS<ul><li>
Communicates regularly with physicians and Physician Organization Central Business Office (PO CBO) staff on clarification to accurately code diagnosis and procedures.
</li><li>Collaborates with management on coding and diagnosis issues to reduce claims denials by providing verbal and written communication.
</li><li>Assists with knowledge sharing, training Coding Specialists, and department cross training; provides support to other team members as advised by the manager and/or supervisor.
</li></ul> 
SERVICE ESSENTIAL FUNCTIONS<ul><li>
Responds to or clarifies internal requests from all business partners for medical coding information in a timely manner.
</li><li>Participates in coding round tables and in-services for continuing education.
</li><li>Cross trains and provides back up coverage of team members to ensure continuous coding and charge capture activities for PO departments.
</li></ul> 
QUALITY/SAFETY ESSENTIAL FUNCTIONS<ul><li>
Codes and abstracts medical records for reimbursement purposes from patient charts, physician documentation, and medical diagnostic and/or interventional reports using current coding conventions and guidelines and tools such as 3M encoder.
</li><li>Reviews individual medical records to verify and substantiate diagnosis and procedures for charge review, claim edit(s) and/or denied claims and submits clinical appeal or corrected claim.
</li><li>Assists with the creation and review of department specific coding workflows and expectations.
</li></ul> 
FINANCE ESSENTIAL FUNCTIONS<ul><li>
Matches charge documents to charge review &amp; claim edit sessions, billing sheets, operative reports, and medical records to ensure correct codes are applied and billable services are captured.
</li><li>Works charge review and claim edit sessions within two business days of posting to the assigned work queues.
</li><li>Investigates and appeals unpaid, denied and partially paid claims by third party payors.
</li></ul> 
GROWTH/INNOVATION ESSENTIAL FUNCTIONS<ul><li>
Pursues ongoing professional growth and development and participation in team meetings.
</li><li>Provides on-going coding and documentation education to physicians and clinical staff.
</li>Attends, in person, quarterly coding and revenue integrity team meetings. 
<li>
</li></ul> 
 
SUPPLEMENTAL REQUIREMENTS 
<ul>
WORK ATTIRE<li><ul><li>
Uniform: No
</li><li>Scrubs: No
</li><li>Business professional: Yes
</li><li>Other (department approved): No
</li></ul></li> 
ON-CALL* 
<li><ul><li>Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.</li></ul></li><li><ul><li>
On Call* No
</li></ul></li> 
TRAVEL** 
**Travel specifications may vary by department**<li><ul><li>
May require travel within the Houston Metropolitan area Yes
</li><li>May require travel outside Houston Metropolitan area No
</li></ul></li></ul></div>QUALIFICATIONS 
 
EDUCATION<ul><li>
High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
</li></ul> 
EXPERIENCE<ul><li>
Five years of professional coding experience
</li></ul> 
LICENSES AND CERTIFICATIONS 
Required
Must have one of the following: &bull; CCS - Certified Coding Specialist (AHIMA) &bull; CPC &ndash; Certified Professional Coder (AAPC) 
<ul><li>
</li></ul> 
Company Profile:
Houston Methodist Specialty Physician Group is an integral part of Houston Methodist&rsquo;s overall strategy to become one of the nation&rsquo;s leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic environment.
Houston Methodist is an Equal Opportunity Employer.</div>

Senior Coding Specialist - Remote - Must Reside in TX

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