Physician Coder I - Hybrid position

Job Summary Position is responsible for coding of physician and/or mid-level provider professional services. Recognize and complete a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follow set procedures to achieve goals. Display professional office skills and ability to navigate a practice management system. Good written and oral communication skills, ability to handle multiple tasks, and work with and train other employees. Ability to serve as liaison between management, the physician practices, and employees working within physician practices. This position is involved in a team‑based approach to care and is trained to meet the highest level of function for its role as per the State of Tennessee/Georgia guidelines. 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 an understanding of National Correct Coding Initiatives, Local Coverage Documents, MUEs, and Medicare Teaching Physician Guidelines, and 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 in an effort to improve upon any areas of 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 and further specify coding of diagnoses, surgeries and procedures documented in the medical record. Provide ongoing feedback to physicians and other providers during charge review. Review and correct EPIC coder claim edits and eValuator edits as needed. Resolve payer denials and respond to inquiries from revenue cycle teams, and process charge corrections as appropriate. Remain current on third‑party payor reimbursement issues, and 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 protect all company confidential information, including but not limited to personal health information. Consistently meet or exceed productivity and quality standards as defined by department leadership. Education Required: High School Diploma or equivalent. Preferred: 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. Experience Required: Demonstrated knowledge of coding to support this position. Ability to work well with people and follow standard practices in coding and reimbursement. High level of concentration for extended periods, data entry proficiency, software/computer experience and/or training, and strong PC experience utilizing Excel, MS Word and Adobe. Preferred: 1‑year professional coding experience in a physician office or facility. Position Requirements Required: None, but ability to achieve a coding credential within 1 year of accepting the position. Training will be provided. Preferred: RHIT, RHIA, CCA, CCS, CPC, or CPC-H. CBCS is grandfathered in for staff currently working for Erlanger. Department Position Summary The employee must demonstrate the knowledge and skills necessary to optimally code professional office, inpatient and outpatient facility encounters, resolve billing issues related to accurate coding, and understand insurance reimbursement requirements. They must show the ability to work in a team, take and give direction, and share responsibility for meeting team goals. Strong communication, critical thinking, and decision‑making skills are essential. The employee must be self‑motivated, evaluate the scope of each day's work, and use time‑management skills effectively. Remote work capability is required. The associate must provide management with annual or bi‑annual proof of certification and complete required continuing education. They 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 Erlanger Health System