Professional Medical Coder I - (Remote)

Vitruvian Health•Cleveland, TN

4d•Remote

About The Position

Under indirect supervision, the associate remotely reviews medical records and assigns/verifies the appropriate CPT and ICD10 code(s) while adhering to published compliance regulations and guidelines. The individual must be detailed oriented, possess initiative, be able to work independently, and must demonstrate the ability to work with physicians and other healthcare providers with cooperation and flexibility. This position serves as a resource for physicians in regard to code assignment issues and related policies and procedures regarding required documentation. The associate reviews assigned work daily, ensures timely charge review and claim creation, and maintains strict confidentiality with regard to protected health information. The individual understands and adheres to HIPAA Privacy & Security policies and procedures.

Requirements

High School Diploma Required.
Base Coding Certification required (CPC, CPC-H, CCA, CCS, CCS-P) along with two additional specialty credentials required.
At least 1 years’ experience coding Evaluation and Management services required
Knowledge of medical record content, medical terminology, anatomy & physiology, ICDCM/PCS & CPT coding systems.
Ability to examine the chart and verify documentation needed for accurate code assignment
Ability to clearly communicate medical coding information to providers, other qualified healthcare professionals, and clinical staff when appropriate.
Knowledge of coding concepts and principles, understanding of medical coding and billing systems, and knowledge of legal, regulatory, and policy compliance matters related to medical coding, documentation and billing.
Ability to apply good judgment, has excellent decision-making skills
Must be able to work in team environment but also work autonomously due to the nature of the position.
Must be detail oriented and consistently produce quality work.
Possess good verbal, written and computer communication skills
Able to perform functions in Microsoft Office.
Must practice excellent self-discipline and time management skills due to its remote nature.
Must remain calm under stress and must be able to appropriately respond to a disgruntled person during such occasions when necessary (i.e., internal and external customers and stakeholders).
Requires payer policy and coding guideline knowledge and research, as well as effective communication with billing staff on resolution steps.

Nice To Haves

Surgical specialty experience preferred.

Responsibilities

Responsible for auditing providers and other qualified healthcare professionals documentation to ensure accurate coding assignment
Assist with ongoing training of providers and other qualified healthcare professionals on documentation rules and regulations, as well as help with training/education of new staff when applicable
Assist in resolving billing issues related to accurate coding
Demonstrates the knowledge and skills necessary to optimally code inpatient and outpatient encounters.
Demonstrates knowledge of the various payment schemes, inpatient and outpatient encounters.
Demonstrates the ability to be flexible as to the type of encounter to be billed.
Is current on required continuing education course and is current with all coding updates.
Reviews provider documentation to determine if appropriate CPT and ICD codes entered is supportive of the documentation provided. This includes OP, IP, procedure notes and or surgical and consult notes (depending on coding assignment).
Sets example of professionalism and promotes Vitruvian philosophy to ensure the quality and continuity of patient care at all times.
Seeks creative and effective ways to problem solve.
Assists providers with explanation and/or resolution of the concern regarding coding inquiries.
Appropriately receives feedback for the purpose of improvement.
Responds positively to situations requiring adaptability.
Recognizes and includes appropriate stake holders in decision making process, escalating situations to management as appropriate.
Collaborates with claims department members as appropriate.
Participates in own annual performance evaluation appraisal by identifying individual goals and reviewing yearly progress.
Responds to communications from other staff in a timely and professional manner.
Anticipates needs, setting standards, scheduling work and measuring results.
Using time in an effective and efficient manner to proactively accomplish daily job tasks.
The ability to recognize and define problems and implement solutions to the problems while considering financial, human, and physical resources.
Initiating the decisions necessary to achieve desired results.
Demonstrates dedication to achieving goals and objectives of the organization.
Accepting, encouraging and using ideas where feasible.
Establishes effective business relationships and demonstrates integrity in dealing in all dealing with people with a good positive attitude.
Effectiveness in controlling expenses in supplies and time management.
Soundness of conclusions, decisions, and actions.
Reliability in executing the commitments and obligations of the position by report for work on time.
Effectiveness in creating, developing, and implementing any new technology.
Ability to take action and get things done without being asked. Assumes responsibility promptly and effectively.
Appropriate knowledge of methods and skills necessary to perform the job responsibilities and an awareness of new developments in the medical field.
Works toward developing a team environment and participates as a team member.
Practices safe work habits and encourages others to do the same.
Follow up on investigations by correcting the unsafe procedure, equipment, or environment.
Routinely resolves coding edits and coding related denials by working from work queues for the respective specialty/responsibility assigned.
Responsible for making coding related charge corrections/resubmission of claims where applicable.