Fully Remote, Outpatient Professional Fee Coder: Family Practice, AssistedLiving, Nursing Home Visi

Southern Illinois Healthcare; Springfield (IL); Remote; USD 31,000 - 49,000; Full time

Job summary

Southern Illinois Healthcare is seeking a qualified medical coder to review provider documentation and assign CPT/HCPCS and ICD-10-CM codes according to official guidelines. Focus areas include provider-based E/M visits and outpatient hospital visits.

The role requires relevant RHIA/RHIT/CCS/CCS-P/CCA/CPC certifications and at least 1 year of CCS-P/CCA/CPC experience, with ongoing CEU maintenance and participation in performance improvement initiatives.

Qualifications

• High School Diploma required; preferred associate or bachelor in health information or related discipline.
• RHIA, RHIT, CCS, CCS-P, CCA or CPC required.
• 1 year CCS-P/CCA/CPC experience (2000 hours).

Responsibilities

• Follows coding policies, procedures, SOPs.
• Uses encoding software and references to assign codes.
• Provider-driven coding: reviews and revises codes per documentation.
• Non-provider driven coding: assigns codes per guidelines.
• Reviews coding edits and resolves to forward encounters to claims.
• Communicates clearly with providers for additional information.
• Identifies issues affecting quality, compliance or productivity.
• Performs work queue duties as assigned by Coding Lead/Supervisor/Manager.
• Maintains coding quality and productivity standards.
• Participates in performance improvement initiatives and meetings.
• Maintains required CEUs.

Education

High School Diploma

Associate or Bachelor Degree in Health Information or related discipline

Tools

RHIA

RHIT

CCS

CCS-P

CCA

CPC

Job description

Position Summary

• Reviews provider documentation and revises and/or assigns ICD-10-CM codes and CPT/HCPCS codes as appropriate, based on official coding guidelines. Researches and takes appropriate action on any coding/claim edits.
• Coding focus is provider based E&M level visits or outpatient hospital based ancillary visits

Principal Accountabilities

• Standards of Performance: Respect, Integrity, Compassion, Collaboration, Stewardship, Accountability, Quality

Education

• High School Diploma required. Preferred Associate or Bachelor Degree in Health Information or a healthcare related discipline.

Licenses and Certification

• RHIA, RHIT, CCS, CCS-P, CCA, or CPC required.

Experience and Skills

• Technical Experience:
• Required for CCS-P, CCA, or CPC - 1 year (2000 continuous working hours).

Role Specific Responsibilities

1. 1. Follows all coding policies, procedures, standard operating procedures
2. 2. Effectively uses encoding software and reference materials to assign appropriate codes.
3. 3. Provider driven coding: Reviews and accepts or revises code selection based upon documentation and coding guidelines.
4. 4. Non – provider driven coding: Reviews provider documentation and assigns appropriate codes based upon coding guidelines
5. 5. Reviews coding edits and accurately resolves so encounter can be sent to claims.
6. 6. Sends clear, respectful communications to provider in basket or queries when additional information is needed before finalizing coding.
7. 7. Identifies and communicates to Coding Lead/Supervisor/Manager any issues related to documentation, coding or systems that may impact quality, compliance, or productivity
8. 8. Performs work que duties as assigned by Coding Lead/Supervisor/Manager.
9. 9. Maintains coding quality and productivity standards
10. 10. Actively engages and makes meaningful contribution when participating in performance improvement initiatives, department meetings and other meetings as required.
11. 11. Maintains required CEU’s

Compensation (Commensurate with experience)

$22.74 To $35.25