Coder I

Eisenhower Health; United States; Remoto; USD 33.000 - 50.000; Tempo integral

Resumo da vaga

Eisenhower Health is seeking a Billing/Coding Specialist to review E/M and simple visit charges in the clinic billing queue, validating service level, place of service, modifiers, and claim creation. You will enter manual charges and resolve simple edits like NCCI, LCD and MUE, ensuring accuracy and compliance.

The role requires at least a high school diploma, with CPC-A/CPC or RHIT certification within 18 months, and one year of billing/charge capture experience.

Qualificações

• High school diploma, GED or higher level degree
• Enrolled in coding certification program or holding an Apprentice Certificate in coding- CPC or CCS; courses in Medical Terminology, Anatomy and Physiology
• CPC-A, CPC, CSC or RHIT Coding Certification within eighteen (18) months of hire
• One (1) year of experience in billing/charge capture coding or related services

Responsabilidades

• Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
• Maintains quality of work based on current published standards.
• Reviews documentation and sequences diagnoses and procedures using current coding guidelines for E&M and simple visit encounters.
• Completes claim information and validates for split or non-split payers.
• Communicates with Coder IIs, department management and clinic staff to obtain needed documentation to ensure correct billing.
• Completes assigned work queue assignments within departmental productivity standards.
• Obtains and maintains a 95% accuracy rate.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient simple visit encounters.
• Performs other duties as assigned.

Conhecimentos

Microsoft Office Suite

Coding software familiarity

Denials & appeals

CMS guidelines & billing

ICD-10-CM & CPT/HCPCS

Medical terminology & anatomy

Written & verbal communication

Formação

High school diploma/GED

Coding certification program or Apprentice CPC/CCS

Medical Terminology, Anatomy & Physiology courses

Descrição da vaga

Default Work Shift:

Day (United States of America)

Hours:

40

Salary range:

$23.97 - $36.42

Schedule:

Full Time

Shift Hours:

8 Hour employee

Department:

Clinic Billing Services

Job Objective:

Reviews E&M and simple visit charges submitted by providers in assigned work queue(s) to validate level of service, place of service, new verses established, and modifier review to ensure valid creation of claim. Reviews and enters manual charges submitted by providers for external services. Reviews and resolves simple NCCI, LCD and MUE edits.

Education:

Required: High school diploma, GED or higher level degree
Preferred: Enrolled in a coding certification program or holding an Apprentice Certificate in coding- CPC or CCS; courses in Medical Terminology, Anatomy and Physiology

Licensure/Certification:

Required: CPC-A, CPC, CSC or RHIT Coding Certification within eighteen (18) months of hire

Experience:

Required: One (1) year of experience in billing/charge capture coding or related services

Reports To: Manager-Coding and Charge Capture Supervises: N/A Ages of Patients: N/A Blood Borne Pathogens: Minimal/ No Potential

Skills, Knowledge, Abilities:

Ability to use Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) and other relevant software applications, Coding software familiarity, Knowledge of Denial and appeals process, Knowledge of general CMS guidelines and general billing guidelines, Knowledge of ICD-10-CM & CPT/HCPCS coding conventions, Knowledge of medical terminology, anatomy and physiology, Written and verbal communication skills

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations. 2. Maintains quality of work based on current published standards. 3. Reviews documentation and sequences diagnoses and procedures using current coding guidelines for E&M and simple visit encounters. 4. Completes claim information and validates for split or non-split payers. 5. Communicates with Coder IIs, department management and clinic staff to obtain needed documentation to ensure correct billing. 6. Completes assigned work queue assignments within departmental productivity standards. 7. Obtains and maintains a 95% accuracy rate. 8. Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient simple visit encounters. 9. Performs other duties as assigned.