Coder I - Professional

SSM Health; St. Louis (MO); Remote; USD 55,000 - 75,000; Full time

Job summary

SSM Health is seeking a Coder I, Professional in a remote capacity. You will review patient information, assign CPT-4 and ICD-10 codes, and ensure compliance with coding guidelines, contributing to timely and accurate charge capture from home.

Responsibilities include analyzing documentation from EHR and other sources, consulting with physicians for clarification, supporting education on documentation improvement, and resolving coding and denial trends to support revenue integrity.

Qualifications

• High school diploma or equivalent

Responsibilities

• Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture.
• Accurately deciphers charge error reasons and plans follow-up steps.
• Identifies all billable services and reviews data sources such as EHR, ADT, Op Logs, nursing home documentation, and procedure reports.
• Posts CPT-4 and ICD-10 codes in the EHR and coordinates record requests as needed to ensure compliance with guidelines.
• Consults with physicians/providers to clarify documentation for accurate coding and provides education on documentation improvement.
• Assists physicians/providers with questions regarding coding and documentation guidelines and communicates trends to leaders.
• Reviews and resolves charge sessions that fail edits and follows up on denials to improve billing.
• Monitors denial trends and shares findings to facilitate root-cause analysis and process improvement.
• Manages charge review, claim edit, and coding follow-up queues.
• Performs other duties as assigned.

Education

High school diploma or equivalent

Job description

It's more than a career, it's a calling

MO-REMOTE

Worker Type

Regular

Job Highlights

Come join us a Coder I, Professional at SSM Health! You will play a crucial role in ensuring accurate and timely coding of medical records. You will be responsible for reviewing patient information, assigning appropriate codes, and ensuring compliance with coding guidelines and regulations. This is a remote position, allowing you to work from the comfort of your own home while contributing to the success of our organization.

Remote work

This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance.

*Candidates to reside in MO, IL, OK, or WI (additional states may be considered)

Job Summary

Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures.

Job Responsibilities and Requirements

PRIMARY RESPONSIBILITIES

• Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps.

• Identifies all billable services. Reviews all applicable data sources, including but not limited to, electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs (aka Op Logs), nursing home visit documentation, procedure reports generated from non-the electronic health record systems, etc.

• Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines.

• Consults with physicians/ providers as needed to clarify any documentation in the record that is inadequate, ambiguous, or unclear for coding purposes. Provides education around documentation improvement for maximum patient care.

• Assists physicians/providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding physician/provider documentation. Identifies opportunities for education and communicates trends to leaders.

• Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow up denials. Works to improve billing based on findings/resolution of errors.

• Is watchful for charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement.

• Manages assigned charge review, claim edit, and coding follow up work queues.

• Performs other duties as assigned.

EDUCATION

• High school diploma or equivalent

EXPERIENCE

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

State of Work Location: Illinois, Missouri, Oklahoma, Wisconsin

• Certified Coding Associate (CCA) - American Health Information Management Assoc (AHIMA)
• Or
• Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Assoc
• (AHIMA)
• Or
• Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC)
• Or
• Certified Professional Coder (CPC®) - American Academy of Professional Coders (AAPC)
• Or
• Registered Health Information Administrator (RHIA) - American Health Information Management Assoc
• (AHIMA)
• Or
• Registered Health Information Technician (RHIT) - American Health Information Management Assoc
• (AHIMA)
• Or
• Certified Professional Coder Apprentice (CPC-A) - American Academy of Professional Coders (AAPC)
• Or
• Certified Coding Specialist (CCS) - American Health Information Management Assoc (AHIMA)

Work Shift

Day Shift (United States of America)

Job Type

Employee

Scheduled Weekly Hours

40

SSM Health is an Equal Opportunity Employer. SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. Click here to learn more. (https://www.ssmhealth.com/privacy-notices-terms-of-use/non-discrimination?_ga=2.205881493.704955970.1667719643-240470506.1667719643)