Remote Claim Edit Coder

Presbyterian Healthcare Services-posted 11 months ago

Full-time • Mid Level

Remote • Albuquerque, NM

5,001-10,000 employees

Hospitals

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Now hiring a Remote Claim Edit Coder. Has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Ensures adherence to Hospital and Departmental Policies and Procedures.

Demonstrate knowledge of coding multiple areas of service and/or specialties or extensive experience in a specific specialty deemed a critical business need by PHS Coding Leadership.
Review patients' entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Access several systems via the computer to research the medical record when needed to complete the coding in a timely manner.
Take responsibility for accounts receivable by looking for lost documents to ensure all encounters are coded, including the generation of appropriate queries, as needed.
Maintain and disseminate up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area.
Resolve any and all pre-bill edits, denials, etc. for assigned accounts.
Participate in all departmental in-services and updates to stay current with the accepted coding guidelines and improve personal knowledge of medicine and treatment.
Communicate issues to the EW Clinical Coding Manager, as appropriate.
Maintain at least a 95% accuracy rate.
Maintain average to high productivity based on PHS Productivity Standards.
Maintain continuing education (CE) requirements per PHS policy.
Perform other functions as required.

Must have any one of the following coding certifications at time of hire: CCS, CCS-P, CPC-H, or RHIT/RHIA with achievement of one of the coding credentials above within one year of hire.
Three to five years experience as a coder required.
Inpatient Coding experience preferred.

Medical
Wellness program
Vision
Dental
Paid time off
Retirement
Short-term and long-term disability
Group term life insurance
Optional voluntary benefits

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