Profee Medical Coder Complex Surgical Pediatric

Banner Health Corporate; Maricopa (AZ); Hybrid; USD 36,000 - 54,000; Full time

Job summary

Banner Health is seeking a motivated Physician Complex Coder with 3 years of Pediatric Profee EM coding and multi-specialty experience. You will code complex pediatric charts, including surgical procedures, and work as an independent E/M coder from a remote setting.

The role requires CPC/CCS/CCS-P/RHIA/RHIT certification in active status. Hours are flexible, 8-hour shift between 5am-7pm (Mon-Fri) with nationwide remote availability.

Qualifications

• 3 years of recent Pediatric Profee EM coding experience.
• Certified through AHIMA or AAPC in active status.
• Complex role requiring more than CPC-A level.

Responsibilities

• Code complex pediatric charts including surgical procedures.
• Ensure ICD/CPT coding accuracy and comply with national guidelines.
• Abstract records and verify information for accurate reimbursement and compliance.

Skills

Pediatric Profee E/M coding

ICD/CPT coding

Remote independent coder

Education

CPC/CCS/CCS-P/RHIA/RHIT certification

Tools

Coding software

Job description

Department Name: Coding Ambulatory Work Shift: Day Job Category: Revenue Cycle Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care.

We are looking for a motivated, experienced Physician Complex Coder with 3 years of General Pediatric coding with multi-specialty experience to join our talented team. In this role, you will cover our Pediatric providers within Banner and will be coding for Complex charts including surgical procedures. Our Profee coders need to be experienced and independent E/M coders. Production expectations depend on what is being coded; straight E/M, procedure, or a minimum of 9 encounters/hr.

Requirements: 3 years recent experience in Pediatric Profee EM coding (clearly reflected in your attached resume); Specialty experience preferred; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. Please note, this is a COMPLEX role, requiring more than a CPC-A level certification.

The hours are flexible with the ability to work your 8-hour shift between 5am-7pm (Monday-Friday). This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY.

Banner Health does provide equipment for you to stay in contact with your team. Although this is a remote position we do work as a team, supporting and educating as we learn together. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you’ll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position evaluates medical records, provides clinical and surgical abstraction for full range of complex and/or multispecialty surgical, procedural and E&M professional services in accordance with nationally recognized coding guidelines. Utilize coding knowledge and expertise to support department projects, validation edits and/or revisions.

CORE FUNCTIONS

• Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
• Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor or individual department for clarification/additional information for accurate code assignment.
• Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
• As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.
• Able to identify validation edits and revision issues to ensure compliant coding.
• Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.
• Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT codes according to national guidelines. May seek guidance for correct interpretation of coding guidelines and LCDs (Local Coverage Determinations).

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field. Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty. Requires three or more years of complex professional coding experience within specialty. Must demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders. Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.

PREFERRED QUALIFICATIONS

Specialty Certification.

• Radiology Certified Coder (RCC) if employed in the Imaging space.
• Experience in a large, multi-system physician practice preferred.
• Additional related education and/or experience preferred.

Estimated Pay Range: $26.05 - $39.07 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

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