Coder II - Behavioral Health

Advocate Health and Hospitals Corporation • Milwaukee, WI

18h • Remote

About The Position

This position will support Behavioral Health and is a full-time role with flexible scheduling, working 40 hours a week, Monday through Friday on the 1st shift. The role involves assigning codes using International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS). The coder will sequence diagnoses and procedure codes according to established guidelines and governmental payer requirements, while maintaining patient record confidentiality and adhering to organizational policies. Responsibilities include reviewing provider documentation to support assigned codes, clarifying documentation when necessary, and upholding ethical coding standards. The role also involves meeting departmental quality and production standards, serving as a subject matter expert, recommending policy modifications, and participating in payer audits. Additionally, the coder will process coding claim appeals and rejections when applicable.

Requirements

• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or Coding Specialist - Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), or Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC).
• Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist.
• Typically requires 2 years of experience in professional coding that includes experiences in physician revenue cycle processes and health information workflows.
• Advanced knowledge of ICD, CPT and HCPCS coding guidelines.
• Advanced knowledge of medical terminology, anatomy and physiology.
• Intermediate computer skills including the use of Microsoft Office and e-mail as well as exposure or experience with electronic coding systems or applications.
• Excellent oral and written communication and interpersonal skills.
• Excellent organization, prioritization and reading comprehension skills.
• Excellent analytical skills, with a high attention to detail.
• Demonstrates ability to function as a mentor, role model and teacher.
• Ability to work independently and exercise independent judgment and decision making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to take initiative and work collaboratively with others.

Nice To Haves

• Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).

Responsibilities

• Assigns codes using International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS).
• Sequences diagnoses and procedure codes as outlined in CPT, ICD and HCPC Coding Guidelines while adhering to local and national governmental payer guidelines.
• Adheres to the organization and departmental guidelines, policies and protocols.
• Maintains the confidentiality of patient records.
• Reports any perceived non-compliant practices to the coding leader or compliance officer.
• Reviews all provider documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes.
• Follows up and obtains clarification of inaccurate documentation as appropriate.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and the American Academy of Professional Coders.
• Adheres to official coding guidelines.
• Practices ethical judgment in assigning and sequencing codes.
• Meets and exceeds departmental quality and production standards.
• Serves as a subject matter expert to Coding department leaders and peers.
• Recommends modifications to current policies and procedures as needed to coincide with government regulations.
• Participates in payer audits by acting as a resource for coding-related audits, as requested.
• Responsible for processing coding claim appeals and coding claim rejections, when applicable.

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees