Forensic Medical Coder

Ensemble Health Partners; Kentucky; Hybrid; USD 34,000 - 37,000; Full time

Benefits offered by this job

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners is seeking a remote Forensic Coder with expert knowledge in front and back end coding to analyze trends and educate teams. The role focuses on root cause analysis, education, and process improvements across client services with frequent collaboration with physicians and leadership.

Minimum 4 years of coding experience, dual certification preferred, and strong knowledge of ICD-10, CPT, and HCPCS.

Qualifications

• 4+ years of coding experience required.
• Extensive knowledge/experience in physician front end and back end coding.
• Knowledge of ICD-10, CPT, and HCPCS.
• Experience with EPIC and coding software tools.
• Dual Certification preferred.

Responsibilities

• Perform root cause analysis of identified front and/or back end coding opportunities as assigned.
• Support/lead opportunity improvement projects as assigned.
• Research and provide coding guidance for new client service lines/services.
• Maintain compliance with policies and procedures and support quality and productivity expectations.
• Mentor and train other coders.
• Remain abreast of payer guidelines, CCI edits, and Local/National Coverage Determinations.
• Communicate professionally with physicians, management, and peers.
• Demonstrate knowledge to provide care appropriate to patient age groups.

Skills

Medical Coding

Front End Coding

Back End Coding

EPIC

ICD-10

CPT

HCPCS

Dual Certification

Microsoft Excel

Education

High School Diploma or GED

AAPC or AHIMA CPC or CCS

Tools

Coding Software Tools

Job description

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose

Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our "Best in KLAS" Ensemble Difference Principles and consistently delivering outstanding results.

CAREER OPPORTUNITY OFFERING

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

This position pays between $24.65 - $27.10/hr based on experience

We are seeking candidates with experience in at least one of the following: General Surgery, Podiatry, Urology, Nephrology, Gyno Oncology, Cardio, Trauma, Ortho, Vascular, and Reproductive Endo

The Forensic Coder is a certified coder with expert knowledge in front and back end coding. This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership.

Job Responsibilities

• Complete root cause analysis of identified front and/or back end coding opportunities as assigned.
• Support/lead opportunity improvement projects as assigned.
• Research and provide coding guidance for new client service lines/services.
• Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations.
• Maintain workflow/process knowledge of each functional area of coding.
• Provide and/or assist with provider education, as well as the development educational tools.
• Communicates professionally with physicians, management, and peers.
• Participates in all educational activities including coding meetings/calls necessary to provide information relating to coding and compliance.
• Remains abreast of changes to current payer guidelines, Correct Coding Initiative edits, and Local/National Coverage Determinations for accuracy in Coding and mentors team members regarding coding guidelines and accuracy.
• Assists with training of other coders.
• Takes initiative for learning new skills and willingness to participate and share expertise on projects, committees and other activities as deemed appropriate.
• Demonstrates personal responsibility for job performance.
• Other duties as assigned by Manager/Supervisor.
• Possible travel for education sessions, CME events, etc. as defined by Physician Revenue Cycle Leadership.
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.
• Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

Experience We Love

• Minimum of 4 years coding experience required, 5 years preferred
• Extensive knowledge/experience in physician front end and back end coding with expert knowledge in a multiple coding specialties and the ability to provide education/support to coding team and providers as well as strong analytic skills.
• Knowledge of Medical Terminology, IDC-10, CPT, and HCPCS.
• PC and Computer application knowledge and experience.
• Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).
• Excellent skills of organization, communication, time management, financial analysis, written policy, trouble shooting and problem solving.
• Ability to multi-task and prioritize needs to meet short and long term timelines.
• Mobile phone access with adequate data to handle business needs is required.
• Experience with EPIC and previous use of coding software tools.
• Dual Certification.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Minimum Education

High School Diploma or GED

Required Certifications

AAPC or AHIMA; Coding Certification: CPC or CCS

Awards

Five-time winner of "Best in KLAS" 2020-2022, 2024-2025; Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024; 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024; Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024; Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023; Energage Top Workplaces USA 2022-2024; Fortune Media Best Workplaces in Healthcare 2024; Monster Top Workplace for Remote Work 2024; Great Place to Work certified 2023-2024

Values

Innovation Work-Life Flexibility Leadership Purpose + Values Bottom line, we believe in empowering people