Pre-Bill Outpatient Coder Specialist

Advocate Aurora Health; United States; Remote; USD 50,000 - 85,000; Full time

Job summary

An established industry player is seeking a detail-oriented Coding Specialist for a remote opportunity. This role involves editing and reviewing patient accounts, ensuring accurate coding, and maintaining compliance with regulatory standards. The ideal candidate will have extensive experience in outpatient hospital coding and relevant certifications. Join a dynamic team that values professional growth and offers flexible working hours. If you're passionate about coding and looking to make a meaningful impact in healthcare, this position is perfect for you.

Benefits

Flexible hours

Remote work opportunity

Professional development seminars

Health benefits

Confidentiality and security training

Qualifications

• 3-5 years of recent outpatient hospital coding experience required.
• Familiarity with 3M OCE report and satisfactory coding test score needed.

Responsibilities

• Edit and correct patient accounts based on daily reports.
• Contact healthcare professionals for necessary coding information.
• Maintain compliance with HIPAA regulations and Advocate policies.

Skills

Attention to detail

Analytical skills

Computer proficiency

Ability to interpret regulatory and payer rules

Education

Certified Coding Specialist (CCS)

RHIT/RHIA

Job description

Department: 10460 Revenue Cycle - Facility Production Coding Admin

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: Flexible hours, Monday through Friday. This is a REMOTE Opportunity.

Major Responsibilities:

1. Edit and correct or coordinate the correction/review of edits generated on the 3M OCE/EAPG report.
2. Review alert against patient record to determine the appropriateness of corrections to patient's accounts based on a daily review of the report.
3. Make revisions with high accuracy to ensure correct claim generation.
4. Maintain proficiency in appropriate corrections, responsible parties, and supporting data.
5. Document activities clearly in the Allegra system.
6. Handle filing, security, confidentiality, retention, and storage of all documents.
7. Combine accounts according to payer requirements when appropriate, reviewing clinical data to identify related or unrelated services.
8. Review and combine accounts timely, prior to claim generation.
9. Contact physicians and healthcare professionals to obtain necessary information for correct coding and charges.
10. Perform other duties as assigned by SRCO/Billing Management.
11. Understand and adhere to Advocate policies, HIPAA regulations, and departmental procedures.
12. Participate in department meetings, training, and process improvement initiatives.
13. Stay updated on system requirements, coding systems (ICD-CM, CPT/HCPCS), and reimbursement methodologies.
14. Assist with ad hoc projects and support department operations during high volume periods.
15. Maintain current knowledge and certification in coding systems, attending educational seminars and peer reviews.
16. Seek opportunities for professional growth and stay informed on insurance regulations and legislation.

Education/Experience Required:

Certified Coding Specialist (CCS) or CCS-P, or RHIT/RHIA with relevant experience. 3-5 years of recent outpatient hospital coding experience, familiarity with the 3M OCE report, and a satisfactory coding test score.

Knowledge, Skills & Abilities:

Attention to detail, analytical skills, ability to interpret regulatory and payer rules, computer proficiency, and relevant certifications.

Physical Requirements and Working Conditions:

Ability to work under pressure, independently, with high accuracy, and collaborate effectively. Capable of working on a computer and speaking on the phone for extended periods. Ability to lift at least 10 pounds.

This description is not exhaustive and may include other related duties as needed.