Physician Coder III, Remote

Job Description Physician Coder III, Remote ( 43806 ) - Erlanger Baroness Hospital Chattanooga, TN Regular - Non-exempt - Full-time - Standard Hours 37.5 Description Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY. REMOTE Job Summary The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS, and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent Care, ED, or a variety of other specialties. Services can include all visit types for a coder I and coder II and includes coding of surgical cases. Responsibilities Review and analyze information available in the electronic medical record and/or paper record to accurately code the episode of care in multiple specialty areas Provide various components of coding services to support our providers Calculate ProFee and/or Facility E/M levels by following the AMA guidelines for E/M assignment Recognize critical care cases by patient acuity Apply ICD-10-CM diagnosis codes to the highest level of specificity available Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, CPT and HCPCS Interpret coding guidelines for accurate code assignment Maintain understanding of National Correct Coding Initiatives, Local Coverage Documents, and MUEs Maintain understanding and apply Medicare Teaching Physician Guidelines Apply knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers Identify the importance of documentation on code assignment and the subsequent reimbursement impact Align conduct with AHIMA's Standards of Ethical Coding and the Company's Code of Ethics and Business Conduct and support the Company's Ethics and Compliance Program Adhere to Det Norske Veritas (DNV) and other third-party documentation guidelines to minimize risk Continuously improve coding quality and accuracy Maintain coding certification and knowledge referencing current ICD-10-CM, CPT and/or HCPCS coding guidelines and regulatory changes Contact the appropriate department or physician office for assistance in obtaining physician clarification of diagnoses, CPT, and/or HCPCS Communicate with physician and non-physician providers to resolve conflicting provider documentation to further specify coding of diagnoses, surgeries and procedures documented in the medical record Provide ongoing feedback to physicians and other providers during charge review Resolve payer denials and respond to inquiries from revenue cycle teams, and process charge corrections as appropriate Comply with all internal policies and procedures Actively participate in company provided training and education Ensure individual compliance with all privacy and security rules and regulations and commit to protection of all company confidential information, including but not limited to personal health information Consistently meet or exceed productivity and quality standards of department leadership Qualifications The Associate must have: Knowledge of anatomy and physiology, disease pathology, and medical terminology Knowledge of basic coding conventions and use of coding nomenclature consistent with CMS Official Guidelines for Coding and Reporting ICD-10-CM coding Accurate translation of written diagnostic descriptions to appropriately and accurately assign ICD-10-CM diagnostic codes, CPT and/or HCPCS to obtain optimal reimbursement from all payer types, including Medicare/Medicaid and private insurance payers Ability to navigate the electronic medical record to identify appropriate documentation for coding/billing in support of submitted department charges Education Required: Validation of coding certification, i.e., specialty focus such as ICD-10 coding, ICD-10 PCS, CPT coding and billing practices from an accredited program Preferred: BS or AS degree in Health Information Management Administration or Health Information Technician from an accredited program Experience Required: Minimum 4 years actual coding experience in either physician office or hospital HIM department, including E/M level code assignment or surgical CPT coding experience in multiple specialties Data entry and keyboard proficiency required Software/computer experience utilizing Excel, MS Word, and Adobe Effective written and oral communication skills, ability to handle multiple tasks, and work with and train other employees Preferred: Experience in both E&M and/or surgical coding and physician office experience One year of EPIC systems experience Ability to audit E/M levels for correct assignment License / Certification / Registration Required: Current registration as a CPC (CBCS is grandfathered for staff already employed by Erlanger) Preferred: Primary specialty certification Department Position Summary The Physician Coder III demonstrates the knowledge and skills necessary to optimally code professional physician accounts including E/M levels and surgical CPT code assignment as well as the ability to resolve all issues including charge and claim edits. The employee must demonstrate knowledge of the various payment and insurance reimbursement schemes for professional physician encounters. The individual must be flexible in the type of encounter to be coded, as well as the ability to work in a self‑directed team by taking and giving direction and sharing responsibility with the team. Must have strong communication, critical thinking and decision‑making skills. The employee must display the ability to be self‑motivated, evaluate the scope of each day's work, and show time management skills to assigned work. Must be able to work effectively in a remote work capacity. The associate must provide management with annual/biannual proof of certification and complete annual/biannual required continuing education. This position must consistently meet or exceed productivity and quality standards as defined by department leadership. The associate will perform any other tasks as assigned. #J-18808-Ljbffr