Coding Specialist II-Profee Orthopedics

Savista; Northern (KY); Hybrid; USD 30,000 - 48,000; Full time

Job summary

Savista is seeking a Pro Fee Coder in Kentucky to review clinical documentation and assign ICD-10/CPT/HCPCS codes for hospital and physician billing. The role ensures accurate coding to meet regulatory guidelines and maximize reimbursement.

Responsibilities include validating APC calculations, auditing records, and maintaining data integrity while upholding HIPAA standards and client-specific quality targets. Strong credentials and at least two years of coding experience are required.

Qualifications

• Active credential (AHIMA or AAPC) required or current certification being pursued.
• Two years of recent hands-on coding experience.
• Knowledge of ICD-10 and CPT/HCPCS coding sets.

Responsibilities

• Select and sequence ICD-10 and CPT/HCPCS codes for various patient types.
• Review facility records to ensure accurate APC/E&M coding.
• Abstract clinical data to support diagnoses, procedures, and discharge disposition.
• Maintain confidentiality and comply with HIPAA guidelines.

Skills

AHIMA/AAPC creds

2 yrs coding exp

ICD-10 CPT knowledge

Medical terminology

MS Office proficiency

Interpersonal skills

Education

Associates degree in HIM

Tools

Rcx

Cerner

NextGen

Job description

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder I may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder I performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder I may interact with client staff and providers.

DUTIES AND RESPONSIBILITIES:

• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type.
• Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record.
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
• Complete assigned work functions utilizing appropriate resources.
• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
• Maintain strict patient and provider confidentiality in compliance with all HIPPA Guidelines.
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

SKILLS AND QUALIFICATIONS:

• Candidates must successfully pass pre-employment skills assessment.
• Required: An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
• Two years of recent and relevant hands-on coding experience.
• Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets.
• Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards.
• Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files, (Outlook, Word, Excel).
• Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers.

PREFFERED SKILLS:

• Recent and relevant experience in an active production coding environment strongly preferred.
• Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience.
• Experience using Rcx, Cerner, NextGen (a plus).

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 - $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.