Edit Coder - Remote PRN

Conifer Revenue Cycle Solutions • Frisco, TX

113d • $20 - $30 • Remote

About The Position

This position will be functioning under moderate supervision while utilizing independent decision making. This position is to problem solve and complete edits with consistency and efficiency. The Edit Coder will investigate and solve edit issues and communicate root cause data to management in order to mitigate potential upstream and downstream impacts. Responsible for modifying and completing moderate to high complexity, reviewing and resolving coding and charge edits using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Working in billing editor systems as required.

Requirements

• Experience with MS Outlook, MS Word, MS Excel.
• Possess technical skills required to learn and navigate a variety of software systems, trouble-shoot computer problems and work efficiently in a virtual environment.
• Strong written and verbal communication skills.
• Ability to think/work independently, yet interact positively with team.
• Advanced problem-solving skills and ability to quickly analyze a situation.
• Attention to detail is critical to this position.
• Outstanding interpersonal communication skills as well as excellent oral and written communication skills.
• Knowledge of medical terminology, anatomy and physiology, disease process, and surgical procedures.

Nice To Haves

• AHIMA RHIT or RHIA or AAPC CCS, CPC approved credential.

Responsibilities

• Performs claim edit reviews on outpatient encounters to validate appropriateness of the CPT codes, HCPCS Level II codes, modifier assignments, APC group appropriateness, review for missed secondary diagnoses and/or procedures, and ensure compliance with all APC mandates and outpatient reporting requirements.
• Monitors medical visit code selection by departments against facility specific criteria for appropriateness.
• Assists in the development of such criteria as needed.
• Addresses CCI and LCD edits within the various billing editor systems while abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
• Meets and/or exceeds Conifer's Edit Coder productivity standards.
• Reviews claim denials and utilizes the medical record for in determining accurate code assignment of all documented diagnoses and procedures adhering to the standards of ethical coding.
• Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM/PCS, ICD-10 initiatives, and CPT/HCPCS coding.
• Stays current with CMS annually updated National Correct Coding Initiative Coding Policy Manual, CMS coding and billing regulations, MUE and OCE.
• Monitors DNFB report for outstanding and/or uncoded encounters to ensure timeliness of coding completion.
• Brings identified issues to department managers for resolution.

Benefits

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match.
• 10 paid holidays per year.
• Health savings accounts, healthcare & dependent flexible spending accounts.
• Employee Assistance program, Employee discount program.
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree