HIM Cert Coder OP Team- Surgical Coder

Carle Health; Champaign (IL); On-site; USD 32,483 - 54,249; Full time

Job summary

Carle Health seeks an HIM Certified Coder to accurately code hospital inpatient, outpatient and professional encounters using ICD-10/ICD-PCS, CPT, and HCPCS. The coder applies regulatory guidelines and modifiers to ensure compliant billing and resolves coding-related Edits in Carle systems.

Qualified candidates hold RHIT or RHIA, plus CPC/COC/CIC/CCS-P/CCS credentials, with strong knowledge of CPT/HCPCS and coding datasets. Equal opportunity employer; E-Verify participant.

Qualifications

• RHIT or RHIA certification required or eligible.
• CPC, COC, CIC, CCS-P or CCS certifications preferred.
• Proficient in ICD-10-CM/PCS, CPT and HCPCS coding and modifiers.

Responsibilities

• Code hospital inpatient, hospital outpatient and professional encounters accurately using ICD-10/ICD-PCS, CPT, HCPCS and modifiers.
• Provide interdepartmental coding assistance to ensure accurate coding assignments.
• Develop compliant coding processes using CMS publications and CPT Assistant as references.
• Assist with audits, training, charge facilitation via scrubber systems, and patient or payer inquiries.
• Serve as expert resource for CPT, HCPCS, ICD-10-CM and other coding guidelines for internal/external users.
• Act as liaison for coding and billing staff to ensure accurate charge capture.
• Report documentation and coding improvement needs from reviews.
• Maintain coding certification and knowledge to perform duties.
• Perform provider and peer coding audits as requested.
• Support internal controls and facilitate external audits.

Education

RHIT certification (AHIMA)

RHIA certification (AHIMA)

CPC (AAPC)

COC (AAPC)

CIC (AAPC)

CCS-P (AHIMA)

CCS (AHIMA)

Job description

Overview

The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters.

Qualifications

• Registered Health Information Technician (RHIT) – American Health Information Management Association (AHIMA)
• Registered Health Information Administrator (RHIA) – American Health Information Management Association (AHIMA)
• Certified Professional Coder (CPC) – American Academy of Professional Coders (AAPC)
• Certified Outpatient Coder (COC) – American Academy of Professional Coders (AAPC)
• Certified Inpatient Coder (CIC) – American Academy of Professional Coders (AAPC)
• Certified Coding Specialist – Physician-Based (CCS‑P) – American Health Information Management Association (AHIMA)
• Certified Coding Specialist (CCS) – American Health Information Management Association (AHIMA)

Responsibilities

• Responsible for accurately coding all records according to the appropriate coding classification (ICD-10 and/or CPT and/or HCPCs and modifiers) system, ensuring codes accurately reflect the diagnoses and procedures pertinent to the patient.
• Provides interdepartmental coding assistance, as needed, to determine accurate coding assignment.
• Develops methodology to provide a coding process that is compliant with regulatory agencies, utilizing reference materials such as CMS publications, Coding Clinic, and CPT Assistant.
• Facilitates optimization of revenue while maintaining compliance standards through auditing, training, charge facilitation via the claim scrubber system, and assisting with patient or payer related charge/account inquiries.
• Serves as an expert resource regarding CPT, HCPCS, ICD-10-CM, and all other necessary coding systems, and regulatory guidelines for all internal and external parties.
• Acts as liaison for coding and billing staff to ensure accurate charge capture.
• Reports documentation and coding improvement needs based on review findings.
• Maintains coding certification, knowledge, and skills to successfully perform job duties.
• Performs provider and peer coding audits as requested.
• Assists with monitoring of internal controls for coding and billing.
• Facilitates external audit activities and reports such activities to the appropriate administrative personnel.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

Salary Range

The compensation range for this position is $23.58 per hour - $39.38 per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered to a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.