Coder, Profee

QHR Health, LLC dba Ovation Healthcare; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Ovation Healthcare seeks a Pro-Fee Coder to code and abstract diagnoses, and to bill procedures from medical records for optimal reimbursement and reporting. This fully remote role emphasizes accuracy, regulatory compliance, and effective communication with providers.

Requires 3+ years of coding experience and credentials such as RHIT/RHIA/CCS-P/CCS or CPC. Remote work experience and proficiency with hospital information systems and billing tools are essential.

Qualifications

• Thorough knowledge of ICD-10-CM and CPT coding systems as used for hospital billing.
• Ability to pass coding assessments and meet quality targets.
• Experience working in a remote environment and using EMR/EHR systems.
• Proficiency with Microsoft Office tools (Outlook, Excel, Teams).

Responsibilities

• Assigns ICD-10-CM and CPT/HCPCS codes for various service accounts.
• Abstracts data elements required for billing and regulatory reporting.
• Reviews records to support accurate charges and documentation.
• Communicates with providers to clarify documentation for accurate coding.
• Resolves claim edits and ensures compliance with billing guidelines.
• Maintains patient confidentiality and participates in ongoing training.
• Supports AR teams in resolving issues as needed.

Skills

ICD-10-CM coding

CPT coding

Remote work experience

Microsoft Office

Communication skills

Multi-tasking

Tools

EMR/EHR systems

Encoder

Billing software

Job description

Welcome to Ovation Healthcare! At Ovation Healthcare (formerly QHR Health), we've been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We're looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visit www.ovationhc.com.

Job Summary

Summary: Ovation Healthcare seeks a Pro-Fee, Coder. This role, under general direction, is responsible for coding and abstracting of diagnoses and charging for procedures from medical records for optimal and timely reimbursement and quality reporting.

Duties and Responsibilities

• Assigns ICD-10-CM codes, and CPT/HCPCS codes for various specialty service accounts, including but not limited to diagnoses, provider level evaluation & management (E/M) charges, and additional CPT-4 procedures.
• Abstracts key data elements required for billing, regulatory agencies, and other databases.
• Reviews records for clinical pertinence and documentation to support accurate facility and provider-based charges for services performed during the encounter.
• Communicates with providers for clarification of documentation to ensure appropriate assignment of diagnoses, procedures, and/or facility and provider evaluation/management (E/M) levels.
• Reviews and resolves claim edits related to emergency department encounters to ensure compliant billing, including but not limited to medical necessity and NCCI/CCI edits.
• Assists with resolution of simple visit coding errors related to other outpatient visits as needed.
• Demonstrates courtesy and professionalism through interaction, appearance, attitude, and written and oral communications with visitors, co-workers, physicians, and other hospital personnel as to represent the Medical Records Services as a high-quality service area of the Hospitals.
• Maintains patient confidentiality as required by Hospitals/departmental policy and industry/legal standards.
• Acknowledges and supports Hospitals defined goals and approach to patient care; attends regular training sessions to improve patient and customer communications.

Knowledge, Skills, and Abilities

• Skill in prioritizing and performing a variety of duties within a system that has frequently changing assignments, priorities, and deadlines.
• Ability to impart knowledge of procedures and techniques.
• Thorough working knowledge of ICD-10-CM and CPT coding systems, and federal/state regulations regarding reimbursement.
• Thorough working knowledge of the hospital information system, electronic medical record systems, and encoder.
• Working knowledge of standards for chart completion.
• Maintains Continuing Education credits in accordance with the American Health Information Management Association's and/or American Academy of Professional Coders' requirements based upon certification(s).
• Performs qualitative analysis of records in accordance with regulatory standards and coding requirements using CPT/HCPCS and ICD-10-CM guidelines.
• Working knowledge of medical-legal rules and regulations that govern the confidentiality and release of medical information with the ability to interpret and implement the standards.
• Must maintain total confidentiality of all patient records.
• Must be comfortable working with AR teams to resolve issues.
• Must be able to pass a coding assessment.
• Must be proficient in Microsoft Office, including Outlook, Excel, and Teams.
• Ability to multi-task and have excellent communication skills.
• Must meet and maintain a 95% quality accuracy rate and productivity standards.
• Must have experience working in a remote environment.

Work Experience, Education, and Certifications

• RHIT, RHIA, CEDC, COC, CPC, CCS-P or CCS Credentials
• Three or more years of Coding experience
• 100% Remote

Ovation will never contact applicants via Chatwork or any other messaging platform outside of our official channels. If you receive any communication claiming to be from Ovation through Chatwork or any unauthorized platform, please disregard it and report it to us immediately. Our official communication will always come from our company email domain or through recognized professional channels like LinkedIn. If you have any questions or concerns regarding the authenticity of a communication, please contact us directly at [e-mail] for verification.

Headquartered in Brentwood, Tenn., Ovation Healthcare partners with 375+ hospitals and health systems across 47 states. For 45+ years, Ovation Healthcare has supported hospitals and health systems through a portfolio of shared services - Leadership Advisory, Spend Management, Revenue Cycle Management, and Technology Services- designed to provide scale and efficiency to hospital business operations.