Coder II - Professional

This role is a remote Coder II Professional at SSM Health, requiring experience coding medical records and abstracting billing information. Successful candidates will accurately assign CPT-4 and ICD-10 codes, review patient data, ensure compliance with coding guidelines, and resolve denials. Job Summary Primarily focuses on coding of high complexity services such as surgical, specialty, high-cost and evaluation and management services. Responsible for resolving coding-related denials. Responsibilities Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies all billable services through review of applicable data sources, including electronic health record, inpatient admission, discharge and transfer reports, operative logs, nursing home visit documentation, procedure reports generated from non‑electronic health record systems, etc. Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT‑4 and ICD‑10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines. Consults with physicians/providers to clarify any inadequate documentation and provides education on documentation improvement. Assists physicians/providers with coding and documentation guidelines and provides ongoing feedback based on observations. Identifies opportunities for education and communicates trends to lead review program. Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow‑up denials. Works to improve billing based on findings and resolution of errors. Trains and mentors coding staff to perform their duties following current coding policies and procedures. Assists coders with medical terminology, disease processes and complex surgical techniques. Manages assigned charge review, claim edit, and coding follow‑up work queues and performs other duties as assigned. Education & Experience High school diploma or equivalent. Two years of professional coding experience. Physical Requirements Frequent lifting of 0–25lb and occasional lifting of 25–50lb; frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements; frequent use of vision and depth perception; frequent use of hearing and speech; frequent keyboard use; occasional bending, stooping, kneeling, squatting, twisting and gripping. Required Professional Licenses and/or Certifications Certified Coding Associate (CCA) – American Health Information Management Association (AHIMA) Certified Coding Specialist – Physician‑Based (CCS‑P) – AHIMA Certified Outpatient Coder (COC) – American Academy of Professional Coders (AAPC) Certified Professional Coder (CPC) – AAPC Registered Health Information Administrator (RHIA) – AHIMA Registered Health Information Technician (RHIT) – AHIMA Certified Professional Coder Apprentice (CPC‑A) – AAPC Certified Coding Specialist (CCS) – AHIMA Work Shift & Location Day Shift (United States). Eligible for remote work in accordance with SSM policies, primarily in MO, IL, OK, or WI (additional states may be considered). State of work location: Illinois, Missouri, Oklahoma, Wisconsin. Benefits Paid parental leave: one week for eligible new parents (pro‑rated based on FTE). Flexible payment options via DailyPay – instant access to earned, unpaid base pay (fees may apply). Upfront tuition coverage through FlexPath Funded for eligible team members. Equal Opportunity Employer SSM Health is an equal‑opportunity employer. We do not discriminate on race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. #J-18808-Ljbffr SSM Health Care St. Louis