Coder II - Pain Management
About The Position
Reviews medical documentation at a proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations an EMR and/or Computer Assisted Coding software. Adheres to the organization and departmental guidelines, policies and protocols. Reviews all clinician 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. Conduct independent research to promote knowledge of coding guidelines, regulatory policies and trends. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement. Maintains the confidentiality of patient records. Reports any perceived non-compliant practices to the coding leader or compliance officer. Meets then exceeds departmental quality and productivity standards. Recommend modifications to current policies and procedures as needed to coincide with government regulations. Responsible for processing Coding Claim Denials and Coding Claim 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)
- Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge)
- Typically requires 3 years of experience in professional coding that includes experiences in either hospital or professional 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 products, electronic mail, including exposure or experience with electronic coding systems or applications.
- Advanced communication (oral and written) and interpersonal skills.
- Advanced organization, prioritization, and reading comprehension skills.
- Advanced analytical skills, with a high attention to detail.
- 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.
Responsibilities
- Reviews medical documentation at a proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS.
- Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations an EMR and/or Computer Assisted Coding software.
- Adheres to the organization and departmental guidelines, policies and protocols.
- Reviews all clinician 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.
- Conduct independent research to promote knowledge of coding guidelines, regulatory policies and trends.
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
- Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
- Maintains the confidentiality of patient records.
- Reports any perceived non-compliant practices to the coding leader or compliance officer.
- Meets then exceeds departmental quality and productivity standards.
- Recommend modifications to current policies and procedures as needed to coincide with government regulations.
- Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable
Benefits
- Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
- Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
- Benefits and more 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
11-50 employees
