Professional Coding and Documentation Improvement Specialist - PT - Day - Physician Professional Coders Remote NJ PA AL

Capital Health System, Inc.; United States; Remote; USD 40,000 - 53,000; Full time

Benefits offered by this job

Medical plan

Rx coverage

Dental plan

Vision plan

FSA healthcare

FSA dependent care

Retirement savings plan

AD&D insurance

Job summary

Capital Health System, Inc. is seeking a qualified Medical Coding professional to ensure accurate diagnosis, CPT and E/M code assignments across our network. You will monitor documentation for compliance, provide provider education, and support documentation improvement initiatives.

The role requires CPC or CCS-P certification, with at least two years of professional coding experience and strong proficiency in EMR systems and Microsoft Office applications.

Qualifications

• Education: HS diploma; Associate's degree preferred; CPC or CCS-P required.
• Two years' experience in professional coding; ICD-10-CM, CPT, CM, HCPCS knowledge.
• Strong communication and documentation skills; knowledge of coding guidelines.
• Proficient with MS Office and EMR systems; ability to educate providers.

Responsibilities

• Review medical records for accurate coding and documentation.
• Monitor codes to ensure medical necessity and compliance.
• Develop and deliver education material on documentation standards.
• Assist in appeals and pre-bill edits.
• Collaborate with revenue cycle teams.
• Attend meetings and respond to documentation issues.

Job description

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range: $29.27 - $38.25

Scheduled Weekly Hours: 20

Position Overview

• Facilitates compliant physician coding and documentation for accurate assignment of diagnosis, Evaluation and Management (E&M) and Current Procedural Terminology (CPT) codes.
• Performs ongoing monitoring of medical record documentation content to ensure all industry guidelines, laws and regulations are met.
• Performs provider feedback and education on proper documentation to support code level selections.
• Identifies and reports recurring coding and documentation improvement areas to leadership to review and respond.
• Reviews and responds to requests for coding and documentation education.
• Supports proactive documentation improvement initiatives within Capital Health Medical Group (CHMG).

MINIMUM REQUIREMENTS

Education: High School Diploma or equivalent. Associate's degree in health information management preferred. Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P) required. Physician coding and Training certification.

Experience: Two years’ experience in professional coding role, monitoring and education experience preferred. ICD-10-CM, CPT, CM, and HCPCS coding experience.

Other Credentials

Knowledge and Skills: Excellent verbal and written communication skills. Knowledge of pathophysiology and disease processes. Strong knowledge of industry guidelines and laws for physician coding and reimbursement. Possesses research and analysis skills.

Special Training

Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint. Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge. Ability to develop, implement and deliver, and assess coding education plans using a variety of methods to individual providers or provider groups.

Mental, Behavioral and Emotional Abilities

Ability to work in environment using multiple EMR systems. Ability to learn and develop documentation and education skills to perform physician education. Ability to work collaboratively with others as well as independently.

Usual Work Day

8 Hours

Reporting Relationships

Does this position formally supervise employees? No

ESSENTIAL FUNCTIONS

• Reviews medical record documentation for accurate assignment and support of diagnosis, CPT, and E&M codes.
• Monitors provider selected E&M codes on a routine and focused basis to ensure documentation supports medical necessity, code specificity, and compliance to promote the highest coding accuracy.
• Develops and delivers education material to promote clear, accurate and complete documentation and compliance with professional coding standards.
• Meets or exceeds departmental accuracy and productivity standards.
• Communicates documentation opportunities and monitoring results in a clear, constructive, and provider-friendly manner.
• Fosters teamwork and collaboration.
• Attends hospital and medical staff meetings to respond to documentation related issues.
• Partners with revenue cycle teams to resolve complex coding-related issues.
• Supports professional coders with pre-bill edits as needed.
• Facilitates change processes required to capture needed documentation on EMR templates.
• Assists in appeals process resulting from third party reviews.
• Acts as a subject matter expert for professional coding and documentation improvement questions.
• Performs all other duties as assigned.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion , Taste or Smell , Talk or Hear Continuous physical demands include: Sitting Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs. Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Minimal Color Discrimination, Accurate Depth Perception, Accurate Hearing Anticipated Occupational Exposure Risks Include the following: N/A

This position is eligible for the following benefits:

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA) - Healthcare
• FSA - Dependent Care
• FSA Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Less than 10 years of service - $5,000
• 10+ years of service - $10,000
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits - Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance - Voluntary Life Spouse
• Voluntary Life Employee
• Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance