Coder - HIM Revenue Cycle - Remote
To accurately code all Physician Office and Hospital charges from all departments supported by the Ambulatory CBO while reducing the number of edits and denials to claims. The coding specialist will be responsible to ensure accurate coding for all services including, but not limited to procedures and surgeries. Responsible for ensuring quality and compliance as it relates to coding and insurance industry practices. Responsibilities will range from limited surgical involvement to major surgical involvement.
1. Accurately code charges for input into the Practice Management System within 72 business hours of receipt.
2. Identify incomplete routers and return them to the provider for completed coding.
3. Reviews all claim edits related to charge entry requirements and corrects the error(s) within 48 business hours.
4. Reviews claims for required documentation attachments and retrieves the information from the E.H.R or requests copies from the provider.
5. Utilizes online services for patient eligibility review, claim status, prior authorizations, and payor requirements.
6. Knows and follows all billing regulations and corporate compliance plans.
7. Performs accurate charge entry if indicated and/or works in conjunction with charge entry staff to assure accurate charge entry.
8. Provide feedback to management on issues that impede timeliness or quality of billing and work with management to resolve.
9. Maintains current payor knowledge for effective claims management and follow up of unresolved claims.
10. Routinely reviews workflows for process improvement and efficiencies and provides feedback to management for implementation of changes.
11. Independently reviews assigned workloads and completion to ensure goals are being met.
12. Acts as a resource for staff.
13. Assist management with training new staff.
14. Perform other duties as assigned.
- Education: Must have a high school diploma or equivalent.
- Skills: Must be able to pass internal coding test and 10-key test.
- Years of Experience: One (1) to five (5) years of previous coding experience
- Certification: CPC, RHIT or RHIA certification required, or must obtain within 90-day probationary period.
- Must have broad CPT, HCPCS and ICD10 knowledge.
- Must demonstrate the ability to independently, and accurately, resolve problems.
- Must be able to understand directions, communicate and respond to inquiries: requires a strong commitment to customer service and effective interpersonal skills.
- Must be able to input and retrieve information from a computer.
- Must have the ability to manage large volumes of work, ability to quickly learn and retain information regarding issues that present themselves.
- Must have strong organizational, quantitative, and analytical skills as well as the ability to multi-task.
- Gastro coding experience is a plus
ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact firstname.lastname@example.org
Equal Opportunity Employer/Drug-Free Workplace
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