Multispecialty Outpatient Medical Coder
US –Remote (Any location)
Full time
Travel Required:
None
Clearance Required:
Ability to Obtain NACI
The Multispecialty Surgery Coder III will Code for Multispecialty Surgery physicians primarily Single Path Coding. Multi-specialty surgical coding experience, any Trauma, Urology, ENT, Plastics, GenSurg, OB/GYN, Cardiovascular, Interventional Radiology, etc. Ability to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.
This position is full time as and 100% remote.
Responsibilities:
- Demonstrates the ability to perform quality surgical coding and multispecialty chart types as assigned
- Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
- Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards
- Achieves and maintains 97% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility
- Ability to maintain average productivity standards as follows
- Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary
- Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines
- Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met
- Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility
- Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request
- Responsible for coding or pending every chart placed in their queue within 24 hours
- It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard
- Coders are responsible for checking the Guidehouse email system at least every two hours during coding session
- Coders must maintain their current professional credentials while working for Guidehouse
- Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility
- Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)
- It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content
- Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services
- Communicates problems or coding principle discrepancies to their supervisor immediately
- Communication in emails should always be professional
What You Will Do:
Demonstrates the ability to perform quality E/M coding and surgical as appropriate on assigned Hospitalist encounters.
- Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing
- Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards
- Achieves and maintains 97% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility
- Ability to maintain average productivity standards as follows
- Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary
- Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines
- Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met
- Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility
- Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request
- Responsible for coding or pending every chart placed in their queue within 24 hours
- It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard
- Coders are responsible for checking the Guidehouse email system at least every two hours during coding session
- Coders must maintain their current professional credentials while working for Guidehouse
- Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility
- Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)
- It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content
- Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services
- Communicates problems or coding principle discrepancies to their supervisor immediately
- Communication in emails should always be professional (reference e-mail policy)
What You Will Need:
- High School Diploma/GED or 3 years of relevant equivalent experience in lieu of diploma/GED, or post-high school education through a university or technical school program resulting in completion of ONE of the following:
- Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology
- Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision
- One of the following recognized professional coding certifications: Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist –Physician (CCS-P)
- 3 years Multi-Specialty Surgery Coding experience, both IP and OP coding for physician claims
- EMR experience
- Must maintain credential throughout employment
What Would Be Nice To Have:
- Certified Inpatient Coder (CIC)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
- Certified Coding Specialist (CCS)
- Recognized E&M coding certifications: Certified Evaluation and Management Coder (CEMC), or National Alliance of Medical Auditing Specialists’(NAMAS) Certified Evaluation and Management Auditor (CEMA)
- Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients
- Knowledge &experience with Federal &State Coding regulations and Guidelines to include DHA or Military Health Coding experience
- Multiple EMR and/or Practice Management systems experience
- Single path coding experience
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
- Medical, Rx, Dental &Vision Insurance
- Personal and Family Sick Time &Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life &Supplemental Life
- Health Savings Account, Dental/Vision &Dependent Care Flexible Spending Accounts
- Short-Term &Long-Term Disability
- Tuition Reimbursement, Personal Development &Learning Opportunities
- Skills Development &Certifications
- Employee Referral Program
- Corporate Sponsored Events &Community Outreach
- Emergency Back-Up Childcare Program