Coder I - Professional

DaMar Staffing; United States; Remote; USD 52,000 - 78,000; Full time

Benefits offered by this job

Paid Parental Leave

Flexible Payment Options (DailyPay)

Upfront Tuition Coverage

Job summary

SSM Health is seeking a Coder I, Professional to join our remote coding team. You will review patient information, assign CPT-4 and ICD-10 codes, and ensure compliance with coding guidelines across outpatient and inpatient settings.

Responsibilities include examining medical records, clarifying documentation with clinicians, resolving coding disputes, and supporting education on documentation improvement. This role requires attention to detail and knowledge of payer guidelines.

Qualifications

• High school diploma or equivalent.
• Certified Coding Associate (CCA) or CCS-P or COC or CPC or RHIA or RHIT or CPC-A or CCS as listed in AHIMA/AAPC.
• Experience with CPT-4 and ICD-10 coding and charge capture workflows.

Responsibilities

• Manages charge review and coding-related claim edit queues to ensure timely, accurate charge capture.
• Identifies billable services and reviews data sources including EHR, ADT, Op Logs, and procedure reports.
• Posts CPT-4 and ICD-10 codes and ensures compliance with Medicare/NCCI guidelines.
• Clarifies documentation with physicians/providers when needed for coding accuracy.
• Educates physicians on documentation improvement and coding guidelines.
• Resolves charge review, claim edit, and coding denials; improves billing outcomes.
• Monitors denial trends and shares insights for process improvement.
• Manages assigned queues and performs additional duties as assigned.

Education

High school diploma or equivalent

CCA - American Health Information Management Assoc (AHIMA)

CCS-P - AHIMA

COC - American Academy of Professional Coders (AAPC)

CPC® - AAPC

RHIA - AHIMA

RHIT - AHIMA

CPC-A - AAPC

CCS - AHIMA

Job description

Coder I, Professional

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

MO-REMOTE

Worker Type: Regular

Job Highlights:

Come join us as 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 my 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

• 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

Department:

Scheduled Weekly Hours: 40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

• Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.