HIM PB Coding Specialist 2

St. Charles Health System; Oregon (IL); On-site; USD 60,000 - 80,000; Full time

Job summary

An established healthcare provider is seeking a PB Coding Specialist II to join their dedicated team. This role involves coding and charging for clinical services while ensuring compliance with industry standards. The ideal candidate will have a strong background in medical coding, excellent communication skills, and a commitment to delivering high-quality patient care. Join a forward-thinking organization that values compassion, teamwork, and continuous improvement. This position offers competitive pay, growth opportunities, and the chance to make a meaningful impact in the community.

Benefits

Competitive Salary

Comprehensive benefits including Medical, Dental, Vision

403b with up to 6% match

Generous Earned Time Off

Growth Opportunities within Healthcare

Qualifications

• Minimum one year of hospital or professional coding experience required.
• Must possess valid RHIT certification or equivalent.

Responsibilities

• Code and charge SCMG Clinical Services, resolving billing edits and denials.
• Ensure compliance with coding guidelines and maintain productivity standards.

Skills

ICD-10 CM knowledge

CPT-4 code assignment

Knowledge of CCI and Medical Necessity edits

Attention to detail

Excellent communication skills

Analytical and problem-solving skills

Education

High School diploma or GED

AHIMA Accredited Health Information Technology program

RHIT certification

Tools

Encoder program

Electronic medical records system

MS Office

Job description

Typical pay range: $24.81 - $37.21 per hour, based on experience.

In addition, this role is eligible to work remotely from an approved state by St. Charles (please refer to the list). If you do not reside in an approved listed state (or do not plan to relocate to an approved listed state) we request, you do not apply for this particular position.

Approved states by St. Charles: Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin.

About St. Charles Health System:

St. Charles Health System is a leading healthcare provider in Central Oregon, offering a comprehensive range of services to meet the needs of our community. We are committed to providing high-quality, compassionate care to all patients, regardless of their ability to pay. Our values of compassion, excellence, integrity, teamwork, and stewardship guide our work and shape our culture.

What We Offer:

1. Competitive Salary
2. Comprehensive benefits including Medical, Dental, Vision for you and your immediate family
3. 403b with up to 6% match on Retirement Contributions
4. Generous Earned Time Off
5. Growth Opportunities within Healthcare

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: PB Coding Specialist II - Advanced Coding

REPORTS TO POSITION: HIM Coding Supervisor

DEPARTMENT: Health Information Management

DATE LAST REVIEWED: May 2024

OUR VISION: Creating Americas healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENTAL SUMMARY: The Health Information Management Departments provide many services to our multi-hospital organization including prepping, scanning and indexing, physician deficiency analysis, release of information, medical record maintenance, facility and profee coding.

POSITION OVERVIEW: The Professional Fee Coding Specialist II at St. Charles Health System is responsible for coding and charging SCMG Clinical Services as well as resolving billing edits and denials. This position does not directly manage other caregivers, however, may be asked to review and provide feedback on the work of other caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

1. Advanced skills in reading and interpreting documents contained in the medical record to identify and code all relevant ICD-10-CM diagnoses and CPT-4 procedures for professional fee charges by utilizing an encoder program, and following National and SCHS coding guidelines, Coding Clinic, CPT-4 and other appropriate coding references and tools to ensure proper code assignment and modifiers.
2. Abstracts medical record information in compliance with CMS requirements and SCHS abstracting procedures as appropriate. Use available tools to check entries for accuracy. This may include data for clinical studies and quality management activities.
3. Captures the correct modifiers appropriate for CPT code assignment.
4. Reconciles CCI and Medical Necessity edits.
5. Maintains productivity and quality standards.
6. Works closely with the Patient Financial Services department on medical necessity issues, claim denials, charge master issues, and charge auditor issues.
7. Supports the vision, mission, and values of the organization in all respects.
8. Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.
9. Provides and maintains a safe environment for caregivers, patients, and guests.
10. Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organizations corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.
11. Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.
12. May perform additional duties of similar complexity within the organization, as required or assigned.

EDUCATION:

Required: High School diploma or GED required. Graduate of an AHIMA Accredited Health Information Technology program or certification in a self-study course from AHIMA or AAPC required.

Preferred: N/A

LICENSURE/CERTIFICATION/REGISTRATION:

Required: Must possess a valid Registered Health Information Technician (RHIT) certification or one or more of the following: RHIA, CCA, CCS, CCS-P, CPC, COC, CPC-H. This position will require the caregiver to maintain required educational credits (CE) through AHIMA or AAPC.

Preferred: Risk Adjustment Coding (micro credential) or AAPCs Certified Adjustment Coder (CRC). Maintains required education credits (CE) through AHIMA and/or AAPC.

EXPERIENCE:

Required: Minimum of one year of hospital or professional coding experience with a Health Information Management focus.

Preferred: Familiarity with 3M encoder.

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Skills:

Position Specific:

1. Knowledge of ICD-10 CM
2. Knowledge of CPT-4 code assignment.
3. Knowledge of CCI and Medical Necessity edits
4. Knowledge of modifiers
5. Maintains professional knowledge by attending educational workshops, reviewing professional publications, participating in educational opportunities.

Communication/Interpersonal:

1. Demonstrates SCHS values of Accountability, Caring and Teamwork in every interaction.
2. Must have excellent communication skills and ability to interact with a diverse population and professionally represent SCHS.
3. Ability to effectively interact and communicate with all levels within SCHS and external customers/clients/potential employees.
4. Strong team working and collaborative skills.
5. Must have a positive attitude, ability to multi-task, pay close attention to details, and be able to act in a professional manner and demonstrate excellent public relations skills.
6. Ability to work in a fast-paced work environment with frequent interruptions, maintaining the highest level of confidentiality at all times.
7. Ability to effectively reach consensus with a diverse population with differing needs.

Organizational:

1. Ability to multi-task and work independently.
2. Attention to detail.
3. Excellent organizational skills.
4. Excellent written and oral communication.
5. Excellent customer service skills, particularly in dealing with stressful personal interactions.
6. Strong analytical, problem solving and decision-making skills.

Language Skills:

Read, write, speak, and understand English.

Computer Skills:

1. Intermediate ability and experience in computer applications, specifically electronic medical records system, and MS Office.
2. Basic experience in computer applications necessary to record time, obtain work directions, and complete assigned CBLs.

PHYSICAL REQUIREMENTS:

Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.
Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.
Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.
Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle.
Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors:
Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category:
No Risk for Exposure to BBP

Schedule Weekly Hours: 40

Caregiver Type: Regular

Shift: First Shift (United States of America)

Is Exempt Position? No

Job Family: SPECIALIST HIM

Scheduled Days of the Week:

Shift Start & End Time: