HIM Cert Coder OP

Carle Health

Champaign (IL)

On-site

USD 50,000 - 80,000

Full time

14 days+

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Job summary

An established industry player is seeking a HIM Certified Coder to ensure accurate coding of hospital encounters using ICD-10, CPT, and HCPCS codes. This role involves applying coding knowledge to resolve billing edits and maintain compliance with regulatory guidelines. The ideal candidate will work closely with billing staff, providing expertise and support to optimize revenue while upholding the highest standards of accuracy. If you have a passion for health information management and coding, this opportunity offers a chance to make a significant impact in a supportive and dynamic environment.

Qualifications

Must maintain coding certification and apply coding knowledge effectively.
Experience with coding audits and compliance with regulatory guidelines.

Responsibilities

Accurately code records using ICD-10, CPT, and HCPCS systems.
Optimize revenue while ensuring compliance through auditing and monitoring.

Skills

ICD-10 Coding

CPT Coding

HCPCS Coding

Regulatory Compliance

Coding Software

Education

Certified Inpatient Coder (CIC)

Registered Health Information Administrator (RHIA)

Certified Professional Coder (CPC)

Tools

Electronic Medical Record Systems

Claim Scrubber System

Job description

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The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient, and/or professional fee encounters using appropriate ICD-10/ICD-PCS, CPT, or HCPCS codes, along with coding software such as computer-assisted coding and encoders. This ensures compliant billing of Carle claims. The HIM Certified Coder must understand and apply all regulatory coding guidelines, including National and Local Coverage Determinations, and CPT modifiers. They are also responsible for applying coding knowledge to resolve billing edits related to coding. The coder uses Carle electronic medical record systems to review clinical encounters.

Responsibilities

Accurately code all records according to the appropriate coding classification system (ICD-10, CPT, HCPCS, and modifiers). The assigned codes should accurately reflect the diagnoses and procedures pertinent to the patient.
Provide interdepartmental coding assistance as needed to ensure accurate coding assignment.
Develop methodologies to ensure a coding process compliant with regulatory agencies, utilizing reference materials such as CMS publications, Coding Clinic, CPT Assistant, etc.
Optimize revenue while maintaining compliance through activities such as auditing, monitoring, training, facilitating charges via the claim scrubber system, assisting with patient or payor inquiries, and researching coding/billing topics.
Serve as an expert resource on CPT, HCPCS, ICD-10-CM, and other coding systems, as well as regulatory guidelines, for internal and external parties.
Act as a liaison for coding and billing staff to ensure accurate charge capture.
Report documentation and coding improvement needs based on review findings.
Maintain coding certification, knowledge, and skills to perform job duties effectively.
Perform provider and peer coding audits as requested.
Assist in monitoring internal controls for coding and billing.
Facilitate external audit activities and report findings to appropriate personnel.

Certifications: Certified Inpatient Coder (CIC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-Based (CCS-P), Certified Outpatient Coder (COC), Certified Professional Coder (CPC) — all from respective professional organizations.

Seniority level