Pre-Bill Coder Specialist - Inpatient

Advocate Aurora Health; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization seeks an experienced Coder to join their team. Key responsibilities include coding and abstracting medical charts with high accuracy, collaborating with departments, and ensuring compliance with coding guidelines. This full-time role offers flexible hours and remote working, fostering a supportive work environment.

Benefits

Comprehensive benefits

Competitive compensation

Retirement plans

Career development programs

Qualifications

• Certification through AHIMA or AAPC is required.
• Advanced proficiency in coding guidelines is necessary.
• Five to seven years of inpatient coding experience in acute care is preferred.

Responsibilities

• Codes and abstracts high-dollar charts with accuracy.
• Reviews complex medical documentation to assign codes.
• Collaborates with departments to clarify coding issues.

Skills

ICD coding guidelines

CPT coding guidelines

HCPCS coding guidelines

Medical terminology

Anatomy knowledge

Physiology knowledge

Analytical skills

Attention to detail

Communication skills

Education

Two-year associate degree

Tools

Microsoft Office

Electronic coding systems

Job description

Department: 10460 Enterprise Revenue Cycle - Facility Production Coding Admin

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: Flexible hours, remote, Monday through Friday

• Prioritizes, codes, and abstracts high-dollar charts, day after discharge, as well as interim charts, at regular intervals, with a high degree of accuracy.
• Reviews complex medical documentation from clinicians, qualified health professionals, and hospitals to assign diagnosis and procedure codes utilizing ICD CM/PCS, CPT, and HCPCS.
• Assigns and ensures correct code selection following Official Coding Guidelines and compliance with regulations, utilizing EMR and/or Computer Assisted Coding software. Codes for present on admission, research, Hospital acquired Conditions, and Core Measure Indicators for all diagnoses both concurrently and post-discharge.
• Collaborates with other departments to clarify pre-bill coding documentation issues for inpatient and outpatient accounts to ensure reimbursement and clinical outcomes.
• Works claim edits for all patient types and may code consecutive/combined accounts to comply with the 72-hour rule and other scenarios.
• Completes informal peer-review on inpatient and outpatient coders.
• Tracks and trends quality information from internal and external sources to partner with the educational team on opportunities.
• Communicates with Medical Staff, CDI, Post-bill for documentation clarification.
• Utilizes EMR communication tools to track missing documentation on inpatient queries requiring follow-up to facilitate coding timely.
• Maintains current knowledge of coding and reimbursement guidelines and regulations, including new applications or settings for coding all patient types.
• Uses critical decision-making skills to determine when to query for documentation clarification independently for outcomes, reimbursement, and benchmarking.

License/Registration/Certification:

• Must have a certification through AHIMA or AAPC

Education:

• Two-year associate degree or equivalent work experience

Experience:

• Five to seven years of inpatient coding experience in an acute care inpatient setting in an academic inpatient care tertiary facility

Knowledge, Skills & Abilities Required:

• Advanced proficiency in ICD, CPT, and HCPCS coding guidelines; advanced knowledge of medical terminology, anatomy, and physiology.
• Excellent computer skills, including Microsoft Office and electronic coding systems.
• Excellent communication, interpersonal, organization, prioritization, and reading comprehension skills.
• Strong analytical skills with high attention to detail.
• Ability to work independently, exercise judgment, and meet deadlines in a fast-paced environment.
• Ability to take initiative and collaborate effectively.

Physical Requirements and Working Conditions:

• Normal office environment; ability to sit for extended periods and concentrate continuously.
• May require travel to other sites, exposure to road and weather hazards.
• Operates necessary equipment to perform the job.

This job description indicates the general nature and level of work expected. It is not exhaustive of activities, duties, or responsibilities. The incumbent may perform other related duties.

#REMOTE

#LI-Remote

Pay Range: $28.05 - $42.10

Our Commitment to You: Advocate Health offers comprehensive benefits, competitive compensation, retirement plans, career development programs, and more to support your well-being both at and away from work.

About Advocate Health: Advocate Health is the third-largest nonprofit, integrated health system in the U.S., created from the merger of Advocate Aurora Health and Atrium Health, serving nearly 6 million patients across multiple states with a focus on clinical innovation and community benefits.