Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible

Memorial Healthcare

104d

About The Position

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. The position involves reviewing medical record documentation and may assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.

Requirements

• High School Diploma or Equivalent (Required)
• Certified Coding Associate (CCA) - AHIMA
• Certified Coding Specialist (CCS) - AHIMA
• Registered Health Information Administrator (RHIA) - AHIMA
• Registered Health Information Technician (RHIT) - State of Florida
• Registered Health Information Technician (RHIT AHIMA) - AHIMA
• One (1) year hospital-based outpatient coding experience for HIM coder.
• One (1) year diagnostic/procedural office coding experience with surgical coding experience for Physician Billing Coder.
• Six (6) months working within the Memorial Health System.

Nice To Haves

• Certified Professional Coder (CPC)
• Certified Professional Medical Auditor (CPMA)
• Certified Risk Adjustment Coder (CRC) by AAPC
• Certified Coding Specialist - Physician Based (CCSP) by AHIMA

Responsibilities

• Enhances and maintains coding knowledge and skills.
• Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes.
• Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.
• Reviews medical record documentation to determine all appropriate diagnosis, procedural and modifier code assignments.
• Codes outpatient diagnostic and therapeutic encounters requiring minimal procedural coding.
• Submits daily productivity report to HIM manager by defined deadline.
• Meets and maintains HIM coding quality and productivity standards.
• Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements.
• May assign and sequence basic CPT procedure codes and modifiers based on medical record documentation.
• Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments.
• Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity.
• Researches medical record for any additional diagnoses documented to meet medical necessity.
• Communicates with insurance companies about coding errors and disputes.
• Abstracts pertinent data points for billing and quality reviews.
• Communicates with various departments as needed to ensure accuracy of patient data.
• Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields.
• Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate.
• Collaborates with billing department to ensure all bills are satisfied.
• Routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing.
• Makes appropriate coding corrections, when advised, and follows procedure to notify billing.

Benefits

• Equal opportunity employer committed to workplace diversity.
• Veteran’s Preference for qualified candidates.
• Reasonable accommodation during the application process.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees