Certified Coder-ProFee I

EvergreenHealth; Kirkland, Northern (WA, KY); On-site; USD 38,000 - 61,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

Dental insurance

Retirement plans

Tuition assistance

Paid time off

Job summary

EvergreenHealth is seeking a medical coder to abstract, analyze, and assign ICD-10-CM, CPT, and HCPCS codes for professional services. You will ensure accurate coding for E/M and procedures, working to uphold quality and productivity standards.

You will communicate coding changes to clinicians and billing teams, resolve denials, and research payer issues. A strong understanding of payer requirements and anatomy is required, with hospital setting experience preferred.

Qualifications

• High school diploma or GED required.
• Current professional coding credential: CPC/CCA/COC (AAPC) or CMC (PMI) or CCS-P/CCS/RHIA/RHIT (AHIMA).
• Strong verbal and written communication skills.
• Proficient knowledge of medical terminology, ICD-10-CM, CPT, and HCPCS conventions.
• Basic understanding of anatomy, physiology and disease processes.
• General understanding of payer billing requirements.

Responsibilities

• Abstract, analyze, and assign ICD-10-CM, CPT, HCPCS codes for professional services.
• Meet department productivity and accuracy standards.
• Communicate code changes and denials to clinicians and staff.
• Evaluate coding inquiries for accuracy based on documentation.
• Research and address payer denials; draft denial appeals.
• Identify coding trends, denials, and revenue risks; report to supervisor.
• Identify documentation improvement opportunities; communicate to supervisor.
• Perform other duties as assigned.

Skills

Communication skills

Medical terminology

ICD-10-CM/CPT/HCPCS coding

Payer billing knowledge

Anatomy & physiology basics

Education

High school diploma or GED

AAPC CPC/CCA/COC

PMI CMC

AHIMA CCS-P/CCS/RHIA/RHIT

Job description

Wage Range: $27.45 - $43.92 per hour

Remote in state of Washington only - Kirkland, WA Campus

Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.

Job Summary

Abstracts, analyzes, and assigns ICD-10-CM, CPT, HCPCS codes and appropriate modifiers for evaluation and management (E/M), minor procedures, and diagnostic tests by using either computerized or manual systems. Researches and resolves coding and reimbursement issues to ensure the accuracy, quality, and integrity of coding and billing practices. Effectively communicates with clinicians and billing/coding teams regarding code changes and denials. Maintains department defined quality and productivity standards.

Primary Duties

• 1. Abstracts, analyzes, and assigns CPT, HCPCS and ICD-10-CM codes for professional services based on documentation in the medical record. Code assignment is primarily for E/M, minor procedures and diagnostic tests and based on industry standards and EvergreenHealth policies.
• 2. Meets department productivity and accuracy standards.
• 3. Promotes a positive working relationship by effectively communicating with clinicians and other support staff regarding changes in the provider’s CPT code selection.
• 4. Evaluates patient coding inquiries to determine coding accuracy based on documentation in the patient’s medical record.
• 5. Evaluates and researches coding denials from payers to determine the appropriate action and drafts appeal letters for Denial Management.
• 6. Identifies and reports trends of code changes, payer denials, missed revenue opportunities and/or compliance risks to the Professional Coding Supervisor.
• 7. Identifies and communicates documentation improvement opportunities to Professional Coding Supervisor.
• 8. Performs other duties as assigned.

License, Certification, Education or Experience

REQUIRED

• High school diploma or G.E.D
• Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Coding Associate [CCA], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT])
• Good written and verbal communication skills.
• Satisfactory completion of general coding skills assessment
• Proficient knowledge of medical terminology, ICD-10-CM, CPT, and HCPCS coding conventions.
• Basic understanding of anatomy, physiology and disease processes.
• General understanding of payer billing requirements.

DESIRED

• One year of professional coding experience in a multi-specialty medical group setting

Benefit Information

Choices that care for you and your family

At EvergreenHealth, we appreciate our employees’ commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff and their loved ones maintain and improve health and financial well-being.

• Medical, vision and dental insurance
• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retirement plans (457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits

View a summary of our total rewards available to you as an EvergreenHealth team member by clicking on the link below. Kirkland Employee Benefits | Kirkland, WA | EvergreenHealth