Coder III - Plastics Specialty

Department:

13495 Enterprise Revenue Cycle - Coding Production Operations: Professional Coding Operations Surgical and Complex

Status:


Full time

Benefits Eligible:

Yes

Hou rs Per Week:

40

Schedule Details/Additional Information:

Will support:

• Will support South East Region Plastics Specialty

Schedule:

• Monday - Friday 1st shift 40 hours a week.

Certification required:

• Academy of Coders (AAPC), OR
• American Health Information Management Association (AHIMA);
• Dual Certifications preferred

Remote opportunity:

• Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

Pay Range
$28.55 - $42.85

Major Responsibilities:

• Accurately assign all codes (ICD-10-CM/PCS, CPT, HCPCS) for highly complex professional fee encounters (highest complexity level) or moderate to high complexity facility encounters

• Serve as the authoritative internal expert for professional coding guidelines or a knowledgeable resource for facility guidelines. Provide expert guidance, training, onboarding assistance, and mentorship to Coder I/II staff to enhance team performance and accuracy

• Provide informal code review guidance as directed by leadership, focusing purely on the accuracy of code assignment and documentation translation for complex cases.

• Review accounts placed on pre-bill hold to address specific coding edits, complex claim issues, and/or denial prevention strategies before final billing

• Master and interpret complex regulatory updates and official coding guidelines (e.g., AHA Coding Clinic), translating changes into actionable processes for the team

Licensure, Registration, and/or Certification Required:

Coding Certification issue by:

• Academy of Coders (AAPC), OR
• American Health Information Management Association (AHIMA);
• Dual Certifications preferred

Education Required:

• Associate's Degree in Health Information Management or equivalent experience/advanced training beyond High School in Medical Coding required

Experience Required:

• Minimum of 5+ years of extensive medical coding experience, with significant experience in complex professional, inpatient, or outpatient facility coding.

• Experience with Epic or similar electronic health record systems is required

Knowledge, Skills & Abilities Required:

• Mastery of medical terminology, anatomy, physiology, and complex pathophysiology for multiple service lines/specialties/types

• Expert knowledge of official coding guidelines, regulatory requirements, and comprehensive reimbursement models (DRG, RVU)

• Exceptional analytical skills to manage the highest level of coding complexity in professional coding and moderate to high complexity in facility coding

• Strong attention to detail and the ability to work independently to solve complex coding problems and interpret nuanced rules

• Strong communication and interpersonal skills to effectively mentor staff and interact with support teams

• Ability to meet deadlines while working in a fast-paced environment and take initiative in a collaborative environment

Supervisory and Management Responsibilities:

• This is a highly advanced, expert individual contributor role. It assumes "lead" responsibilities in expertise, mentoring, and informal quality checks but has no formal management responsibility

Physical Requirements and Working Conditions:

• Exposed to normal office environment in a remote work setting

• Job may require occasional travel for training or meetings, therefore, may be exposed to road and weather hazards

• May need to be able to lift up to 40 lbs. occasionally (e.g., equipment)

• Sits the majority of the workday, but also may lift, reach, and bend throughout the day

• Operates all equipment necessary to perform the job

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

#REMOTE

#LI-REMOTE

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.