HIM Cert Coder OP Team- Surgical Coder

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

Job summary

Carle Health in Urbana, IL seeks a HIM Certified Coder to accurately code inpatient, outpatient and professional encounters using ICD-10-CM/PCS, CPT and HCPCS codes. You will utilize coding software and reference materials to ensure compliant Carle claims.

Qualifications include RHIT/RHIA/CPC/COC/CIC/CCS-P/CCS certifications with ongoing credential maintenance. The role supports audits, education, and collaboration with billing to optimize revenue.

Qualifications

• RHIT/RHIA/CPC/COC/CIC/CCS-P/CCS certification(s) required.
• Active coding certification and credential maintenance expected.
• Experience coding inpatient, outpatient and professional encounters preferred.

Responsibilities

• Code inpatient, outpatient and professional encounters accurately using ICD-10-CM/PCS, CPT and HCPCS.
• Apply coding guidelines and modifiers to ensure compliant billing.
• Conduct provider/peer audits and support coding education.
• Coordinate with billing and auditing teams to optimize revenue while maintaining compliance.

Skills

RHIT

RHIA

CPC

COC

CIC

CCS-P

CCS

Education

RHIT AHIMA

RHIA AHIMA

CPC AAPC

COC AAPC

CIC AAPC

CCS-P AHIMA

CCS AHIMA

Tools

Coding software/encoders

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

Certifications: 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. The assignment of codes will 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 including the utilization of reference materials such as, but not limited to, Center for Medicare Services (CMS) publications, Coding Clinic, CPT Assistant, etc. Facilitates optimization of revenue while maintaining compliance standards for the organization through varied venues and tasks (auditing/monitoring, training, facilitation of charges through the claim scrubber system, assisting with various patient or payor related charge/account inquiries, research on various coding/billing related topics as requested by various sources internal and external to the organization, etc.). Serves as an expert resource regarding CPT, HCPCS, ICD-10-CM, all other necessary coding systems, and regulatory guidelines for all internal and external parties. Serve as liaison for coding and billing staff to ensure accurate charge capture. Reports any documentation and coding improvement needs based upon review findings. Responsible for maintaining coding certification, knowledge and skills to successfully perform job duties. Performs provider and peer coding audits as requested. Assist with monitoring of internal controls for coding and billing. Facilitates external audit activities and reporting of such activities to the appropriate administrative personnel.

EEO Statement

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. For more information: [e-mail].

Compensation and Benefits

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.