Coder II - Professional

SSM Health; St. Louis (MO); Remote; USD 33,000 - 52,000; Full time

Job summary

SSM Health is seeking a remote Coder II Professional to accurately code and abstract medical records for billing and reimbursement. You will review patient information, assign codes, and ensure compliance with coding guidelines from a home office.

This role requires 2+ years coding experience and eligibility for remote work per policy. The position emphasizes high-complexity coding, including surgical and specialty services, with responsibilities for resolving denials and supporting education

Qualifications

• Two years of professional coding experience required.
• Experience coding high complexity encounters.
• Familiarity with Medicare/NCCI and payer guidelines.
• Ability to review and abstract medical records for billing purposes.

Responsibilities

• Manages charge review and coding-related claim edit work queues for timely capture.
• Identifies billable services from data sources including EHR, ADT, operative reports, and other records.
• Delivers CPT-4 and ICD-10 codes to EHR; requests records from outside the organization as needed.
• Clarifies documentation with physicians/providers to improve coding accuracy.

Skills

CPT-4 coding

ICD-10 coding

Medical record review

Regulatory compliance

Education

High school diploma or equivalent

CCA - AHIMA

CCS-P - AHIMA

COC - AAPC

CPC - AAPC

RHIA - AHIMA

RHIT - AHIMA

CPC-A - AAPC

CCS - AHIMA

Job description

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

MO-REMOTE

Worker Type:

Regular

Job Highlights:

Experience : 2+ years of professional coding experience is required.

Come join us as a remote Coder II Professional at SSM Health! You will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. 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 SSM Health.

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 high complexity, such as surgical, specialty service, higher than average cost services, evaluation and management services. Responsible for resolving coding related denials.

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 through review of all applicable data sources, including but not limited to: electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative 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 lead

• 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.

• Trains and mentors coding staff to effectively perform their job responsibilities following current coding policies and procedures. Assists coders with medical terminology, disease processes and complex surgical techniques.

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

• Performs other duties as assigned.

EDUCATION

• High school diploma or equivalent

EXPERIENCE

• Two years\' experience

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

• Frequent keyboard use/data entry.

• Occasional bending, stooping, kneeling, squatting, twisting and gripping.

• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

• Rare climbing.

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

Department:

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.