Coder II - Professional

SSM Health; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

SSM Health is hiring a remote Coder II Professional to accurately code and abstract medical records for billing. This role focuses on high-complexity coding, including surgical and evaluation and management services, with denials resolution and adherence to payer guidelines.

Eligible for remote work, with state limitations consulting HR. Requires 2+ years of coding experience and a high school diploma; MO, IL, OK or WI residency is preferred.

Qualifications

• Two years of professional coding experience required.
• Experience with CPT-4 and ICD-10 coding.
• Ability to review medical records and assign codes.
• Knowledge of Medicare and payer guidelines.
• Strong communication with physicians for documentation improvement.

Responsibilities

• Manages charge review and coding-related claim edits to ensure timely, accurate charge capture.
• Identifies billable services through review of data sources (EHR, ADT, operative logs, etc.).
• Reviews documentation and posts CPT-4 and ICD-10 codes; requests records as needed.
• Consults with physicians for documentation clarification to improve coding accuracy.
• Trains others and shares education on coding policies and procedures.
• Resolves charge sessions failing edits and follows up on denials.
• Performs other duties as assigned.

Skills

Medical coding

CPT-4 ICD-10

Charge review

Documentation guidance

Physician collaboration

Education

High school diploma

Tools

EHR systems

NCCI guidelines

Coding software

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.