Professional Fee Abstractor

Nemours Children's Health • Ferry Pass, FL

1d • $21 - $34 • Remote

About The Position

Nemours Children's Health is seeking a remote Professional Fee Abstractor. This role involves assessing each professional session (claim) for all documented conditions and applying M.E.A.T. criteria (monitoring, evaluation, assessment, treatment) to accurately apply ICD 10 CM codes for diagnoses, evaluation & management CPT codes, procedure codes, HCPCS codes, and modifier application per payer-specific guidelines. This is a remote position.

Requirements

• CPC, CCS-P, RHIA, or RHIT required.
• 3-5 years ICU/Critical Care coding experience
• High School Diploma Required.

Nice To Haves

• CRC, CEMC preferred
• Medical Terminology and Anatomy and Physiology preferred
• Associate's preferred

Responsibilities

• Ability to comprehend medical record documentation to assign codes for each active session, in multiple specialties. (i.e. Codes assigned by provider are evaluated and modified with the approval of the provider)
• Codes a minimum of 60-100 sessions per shift. The number of lines per session varies, therefore, “Coding Required” sessions are completed daily.
• Works collaboratively in a team setting with providers, allied health staff, business office staff throughout the enterprise to achieve accurately coded 1500 claims.
• Analyzes high-risk encounters for accurate charge capture and makes recommendation before transferring to second level review work queues.
• Facilitates modifications to clinical documentation to ensure that information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC) and risk adjustment factors (RAF).
• Understands complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with un-clear, nonspecific, or un-substantiated care rendered.
• Crossover coding is expected to help in any and all professional sessions (as assigned) using written reliable methods which identifies standard work requirements by session type.
• Communicates with providers directly for clarification or gaps in documentation prior to submitting the session to assign the code(s) which fit services rendered.
• Maintains production and accuracy objectives (i.e. metrics) identified annually.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED