Clinical Documentation Improvement / Certified Professional Coder

Palm Medical Centers; Remote; USD 40,000 - 60,000; Full time

Job summary

A healthcare organization based in Miami, Florida, is seeking a CDI/Certified Professional Coder to ensure compliance with medical coding standards and improve business performance. The successful candidate will conduct coding workflows, educate healthcare providers, and perform audits to ensure accurate documentation. Candidates must have a CPC certification and at least two years of experience in coding, with excellent communication and organizational skills. This is a full-time remote position offering various benefits including health insurance and paid time off.

Benefits

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k)

Paid time off

Qualifications

• Certified Professional Coder (CPC) through AAPC or AHIMA is mandatory.
• Minimum two years of experience in coding.
• Proficiency in ICD-10-CM coding is required.

Responsibilities

• Conduct coding workflows and ensure documentation accuracy.
• Educate physicians on compliance standards.
• Perform audits for completeness and coding accuracy.

Skills

Excellent verbal and written communication skills

Excellent customer service skills

Excellent organizational skills and attention to detail

Proficient in coding standards

Education

Certified Professional Coder (CPC) through AAPC or AHIMA

2 years of experience as Certified Professional Coder

Tools

Microsoft Word

Excel

EMR systems

Job description

At Palm Medical Centers (PMC) our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of.

With more than 24,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve.

Every day, we deliver on our promise to bring value based, quality healthcare to our patients.

Overview

PMC is looking for a CDI/Certified Professional Coder who will demonstrate deep knowledge in Medical Risk Adjustment, HEDIS, CNS Coding guidelines, billing standards and regulations. A teamwork person who will deliver a high standard of quality of work to drive improved business performance.

Duties And Responsibilities

• Conduct workflows in Coding and Quality processes, medical record completion and department projects for accuracy in medical record documentation as needed
• Ensures proper code selection for compliance with ICD-10-CM Official Guidelines for Coding and Reporting
• Educates physicians on proper documentation and compliance standards
• Reviews medical record to include consultations (inpatient and outpatient) and hospital discharge summaries to ensure continuity of care and continued coding for accurate risk adjustment
• Performs pre-post audits to ensure medical record completeness, consistency, and compliance
• Works collaboratively with medical and supporting staff to follow-up on documentation needs to support the diagnosis and quality measures based on patient age and chronic conditions
• Uses only pre-approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure
• Develops and maintains professional skills and knowledge through training programs including education sessions for ICD-10-CM and CPT codes
• Demonstrates a thorough understanding of Coding Guidelines
• Demonstrates understanding of company policies which impact Coding functions and takes ownership for compliance for own area of responsibility
• Collaborates with Supervisor as necessary to clarify and verify information. Reports opportunities identified in concurrent and retrospective clinical documentation to support quality, regulatory compliance, and effective coding
• Participates in department meetings. Consistently demonstrates awareness and willingness to fulfill Service Excellence Commitments
• Works collaboratively with team members, other departments, and clinical staff consistent with the Mission and Vision of the company
• Willingly performs similar or related tasks as assigned
• Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary
• Reports any issues to Quality, Compliance and Operations as necessary
• Accurately enters all identified and validated procedures codes in claims into the practice’s EMR
• Assists in all RAPS submission projects as they occur if needed
• Performs all other coding and documentation reviews and/or projects as asked and assists/coordinates strategies as defined by the department head or assistant

Education and Experience

• Certified Professional Coder (CPC) through AAPC or AHIMA
• 2 years of experience as Certified Professional Coder at minimum
• Proficient in assigning ICD-10-CM codes according to provider documentation level to comply with federal regulations and insurance requirements
• Computer skills, Word, Excel, HER
• Ability to travel to medical centers if needed and/or work remotely
• Foreign graduate, nurse, or some Medical background is a plus

Required Skills/Abilities

• Excellent verbal and written communication skills
• Excellent customer service skills
• Excellent organizational skills and attention to detail
• Ability to effectively present information in one-on-one situations to providers, office staff, insurance companies, and other employees
• To perform this job successfully, an individual must have knowledge of Microsoft Word, Excel, Internet software, Email software, and insurance web sites
• Strong sense of business ethics
• Ability to follow company policies and procedures

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer
• While performing the duties of this job the employee is regularly required to sit, use hands and arms, talk and hear
• Must be able to lift up to 10 pounds at times

Benefits

• Health insurance
• Dental Insurance
• Vision insurance
• Life insurance
• 401(k)
• Paid time off

Schedule

• 8 hour shift
• Day shift
• Monday to Friday

Job Type: Remote / Full-time

Palm Medical Centers is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Medical Centers makes hiring decisions based solely on qualifications, merit, and business needs at the time.