Medical Coder

Job Family:General CodingTravel Required:NoneClearance Required:NoneThe Multispecialty Coder 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.Responsibilities:Demonstrates the ability to perform quality surgical coding and multispecialty chart types as assignedMaintains 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 standardsAchieves and maintains 97% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facilityAbility to maintain average productivity standards as followsWorks 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 necessaryCharts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelinesCoder downtime must be reported immediately to the administrative staff to ensure turnaround is metResponsible for working directly with the IQC staff to ensure quality standards are being met for each facilityProvides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of requestResponsible for coding or pending every chart placed in their queue within 24 hoursIt is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standardCoders are responsible for checking the Guidehouse email system at least every two hours during coding sessionCoders must maintain their current professional credentials while working for GuidehouseCoders 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 facilityCoders 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 contentWorks well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented servicesCommunicates problems or coding principle discrepancies to their supervisor immediatelyCommunication in emails should always be professionalWhat 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 billingAssures 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 standardsAchieves and maintains 97% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facilityAbility to maintain average productivity standards as followsWorks 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 necessaryCharts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelinesCoder downtime must be reported immediately to the administrative staff to ensure turnaround is metResponsible for working directly with the IQC staff to ensure quality standards are being met for each facilityProvides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of requestResponsible for coding or pending every chart placed in their queue within 24 hoursIt is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standardCoders are responsible for checking the Guidehouse email system at least every two hours during coding sessionCoders must maintain their current professional credentials while working for GuidehouseCoders 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 facilityCoders 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 contentWorks well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented servicesCommunicates problems or coding principle discrepancies to their supervisor immediatelyCommunication in emails should always be professional (reference e-mail policy)What You Will Need:High School Diploma/GEDActive participation in current Guidehouse's CPC-A training programWhat Would Be Nice To Have:Must be able to work independently, multi-task well and interface with all levels of personnel as well as clientsMultiple EMR and/or Practice Management systems experience#LI-DNIWhat 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 InsurancePersonal and Family Sick Time & Company Paid HolidaysPosition may be eligible for a discretionary variable incentive bonusParental Leave401(k) Retirement PlanBasic Life & Supplemental LifeHealth Savings Account, Dental/Vision & Dependent Care Flexible Spending AccountsShort-Term & Long-Term DisabilityTuition Reimbursement, Personal Development & Learning OpportunitiesSkills Development & CertificationsEmployee Referral ProgramCorporate Sponsored Events & Community OutreachEmergency Back-Up Childcare ProgramAbout GuidehouseGuidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at View phone number on click.appcast.io or via email at View email address on click.appcast.io. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or View email address on click.appcast.io. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact View email address on click.appcast.io. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee. #J-18808-Ljbffr