Coder 3

Fairview Health Services; Saint Paul (MN); On-site; USD 75,000 - 110,000; Full time

Job summary

Fairview Health Services is seeking a Coder 3 for a full-time, benefit-eligible position focused on highly complex coding in outpatient and professional accounts. You will assign ICD-10-CM, CPT-4, and HCPCS codes and support billing and regulatory reporting to ensure accurate reimbursement.

The ideal candidate will demonstrate expert knowledge of coding guidelines, strong research and problem-solving abilities, and the capacity to work independently. A CIRCC credential is preferred.

Qualifications

• Completion of an accredited coding certificate program or a Health Information Technician program.
• Minimum of 2 years coding experience.
• Outpatient or professional coding with applicable certifications.

Responsibilities

• Assign ICD-10-CM, CPT-4, or HCPCS codes to diagnoses, treatments, and procedures on complex outpatient or clinical visits.
• Research and resolve complex coding issues with appropriate documentation.
• Ensure coding aligns with regulations and payer requirements.
• Extract data from EMR and enter into coding/abstracting systems.
• Identify chargeable items and ensure timely billing and reimbursement.
• Educate clinicians on coding changes and compliance guidelines.

Skills

ICD-10-CM coding

CPT coding

HCPCS coding

Clinical documentation review

Query physicians

Regulatory compliance

Research skills

Education

Coding certificate program

Health Information Technician program

Tools

Encoder software

CAC software

EMR systems

Job description

Job Overview

Fairview is looking to add a Coder 3 to our team. This is a full-time, benefit-eligible position designed for an experienced coding professional with advanced expertise in complex coding.

Job Overview

Fairview is looking to add a Coder 3 to our team. This is a full-time, benefit-eligible position designed for an experienced coding professional with advanced expertise in complex coding. The Coder 3 is responsible for handling highly complex coding assignments and requires expert-level knowledge of coding guidelines, regulations, and reimbursement practices. The ideal candidate will demonstrate strong critical-thinking and research skills, exceptional attention to detail, and the ability to independently resolve complex coding scenarios. A CIRCC (Certified Interventional Radiology Cardiovascular Coder) credential is preferred. This is a clinical or hospital-based coding position for an experienced coder working with specialty professional or hospital outpatient accounts. OP Coder 3 will have specialized knowledge in Interventional Radiology and Heart Catheterization. OP Coder 3 will competently assign ICD-10-CM, CPT-4, HCPCS codes to more complex outpatient accounts for billing, internal and external reporting, research, and regulatory compliance. Utilizes an encoder and/or computer assisted coding (CAC) software to achieve accurate and thorough coding. Is responsible for assigning APC weights, resolving medical necessity edits, and extracting data for the medical record abstract. Researches complex coding scenarios. OP Coder 3 analyzes clinical documentation; assigns appropriate diagnosis, procedure and level of service codes; and abstracts the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements.

Responsibilities

• Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
• Actively participates in creating and implementing workflow improvements.
• Assigns ICD-10-CM, CPT-4, or HCPCS codes to all diagnoses, treatments, and procedures on complex hospital outpatient or clinical department visits.
• Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned.
• Is able to research and understand simple and moderately complex coding issues.
• . Is proficient in using various coding software. Is able to problem solve simple computer issues.
• Utilizes technical coding principles and/or APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT-4 procedures. Assigns modifiers to CPT codes.
• Extracts required information from electronic medical record and enters into coding software and abstracting system.
• Identifies chargeable items for department visits and enters into computer system.
• Follows-up on unabstracted accounts to assure timely billing and reimbursement.
• Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication.
• May query physicians on documentation according to established procedures and guidelines.
• Meets productivity and quality standards as established by coding managers.
• Educate multidisciplinary team members, including physicians, about frequently changing mandated rules, regulations and guidelines to ensure a compliant claim.
• Identify and resolve clinical documentation and charge capture data discrepancies to improve quality of the clinical documentation, complexity of reimbursement levels assigned, and integrity of data reported.
• Timely and accurate work.
• Contributes to the process or enablement of collecting expected payment.
• Understands and Adheres to Revenue Cycle’s Escalation Policy.

Required Qualifications

• Completion of an accredited coding certificate program or a Health Information Technician program.
• 2 years of coding experience
• Outpatient or Professional Fee Coding: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist - Professional (CCS-P) or Certified Professional Coder - Hospital (CPC-H) or Certified Outpatient Coder (COC) or AAPC specialty certifications

Preferred Qualifications

• Associate of Science in Health Information
• Bachelor of Science in Health Information
• 2 years of coding experience with a variety of professional and hospital accounts - i.e. Observation, Surgical outpatients, Interventional Radiology, Heart Catheterization, Professional billing surgical specialty
• Certified Interventional Radiology Cardiovascular Coding (CIRCC)

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link foradditional information: https://www.fairview.org/careers/benefits/noncontract

Compensation Disclaimer

An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.

EEO Statement

EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status