Medical Coding Specialist

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. Customer Obsession:

Embracing New Ideas:

Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

Bonus Incentives

Tuition Reimbursement

HemOnc/Interventional Radiology, Ortho, Allergy/ENT, OBGYN, Cardio, General Surgery, Pediatric General Surgery & Pulmonology

The Medical Coding Specialist position reviews medical record documentation and accurately assign ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications. Utilizing Coding Applications in accordance with established workflow. Follows Policies and Procedures and maintains required quality and productivity standards.

Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types. The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management, (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third party software systems such as LYNX.

Correctly abstract required data per facility specifications.

Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines.

Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensure timely, compliant processing of outpatient claims in the billing system.

Responsible to maintain established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards.

Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through.

Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy

Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth.

1 year of previous of coding experience

~ PC and Computer application knowledge and experience. Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).

~ Ability to multi-task and prioritize needs to meet short- and long-term timelines.

~ Experience with EPIC and previous use of coding software tools.

~ This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

High School Diploma or GED

AAPC or AHIMA Coding Certification: CPC-A, CPC, CCA or CCS

#LI-REMOTE

Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Associate Benefits –

We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.

Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact

equity;