Coder - Certified

Confluence Health•Wenatchee, WA

9h•Hybrid

About The Position

This is a pool position with no guarantee of hours. Certified Coders have the option to work virtually, provided they reside in WA, OR, ID, WI, FL, MT, GA, TX, AZ, AL, or TN. The Certified Medical Coder is responsible for reviewing all medical record information to extract data and apply appropriate diagnoses and procedure codes for billing, internal and external reporting, research, and regulatory compliance. This role accurately codes conditions and procedures as documented in the Official Guidelines for Coding and Reporting for Hospital Departments. The coder acts as a coding resource for team members and medical staff, ensuring coding practices align with established compliance guidelines for ICD-10CM/PCS, CPT & HCPCS according to the American Medical Association (AMA) and CMS. They will assign codes utilizing an electronic encoder application in accordance with practice policy and regulatory guidelines. A strong knowledge of medical terminology, anatomy & physiology, and pharmacology is required. The Certified Medical Coder will abstract and assign ICD-10-CM/PCS, CPT, or HCPCS codes per coding guidelines and assist with coding audits and rebuttals from payor and RAC audits when due to coding.

Requirements

High School graduate or equivalent.
One of the following coding certifications: CPC, CIC, COC from American Academy of Professional Coders (AAPC) or CCA, CCS, RHIA, RHIT from American Health Information Management Association (AHIMA).
Minimum 1 year coding experience or equivalent education/experience.
Knowledge of ICD-10, CPT coding, medical terminology, and insurance billing.
Understanding of DRG’s for Inpatient Facility coding positions.
Possesses basic computer (e.g., spreadsheets, word processing) skills.

Nice To Haves

Experience with EPIC EHR.
Facility coders: Experience with Nuance Clintegrity encoder system.
Second coding certification from AAPC or AHIMA.

Responsibilities

Reviews accounts and charges in EPIC.
Codes all records based on documentation, following coding guidelines, payer regulations and ethics.
Demonstrates knowledge of CMS Hierarchical Condition Category (HCC) Risk Adjustment coding.
Applies knowledge of coding rules, reviews and resolves CCI/LCD/NCD’s and modifier edits.
Effectively uses software and/or coding books to verify coding accuracy.
Stays current with billing guidelines and reimbursement rules and regulations.
Works with Revenue Integrity & Compliance on audits and coding questions.
Contributes as a team member with Clinical Documentation Specialists.
Provides feedback to providers regarding incorrect coding using authorized methods as directed by department policy, such as physician queries for incomplete/contradictory diagnosis or greater specificity.
Works with clinical staff to resolve coding issues and related problems.
Assists with coding audits rebuttals from payor and RAC audits when due to coding.
Participates in educational activities as requested (i.e., attending meetings with clinical staff).
Maintains department coding production standards for assigned specialties.
May be requested to perform job tasks not specifically related to primary assignments for the success of the organization as requested by management.
Other duties as assigned.
Hospital Professional Coders are responsible for coding charges for Inpatient/Outpatient Hospital, Emergency Department and/or Ambulatory Surgical Center.
Clinic Outpatient Professional Coders are responsible for coding multiple specialties with a broad range of health care facility types following Rural Health, Freestanding and/or Provider Based Department guidelines.
Utilizes ICD-10CM, CPT, Modifiers and HCPCS codes for reporting diagnosis and procedures per coding guidelines.
Reviews charge session for appropriate billing provider, department, and place of service.
Ability to level E/M visits and extract procedure codes.
Receives paper charge tickets or invoices, appropriately codes them, creates HARs and then batches or unit charges into EPIC.
Demonstrates Standards of Behavior and adheres to the Code of Conduct in all aspects of job performance at all times.