Professional Medical Coder I

Lexington Health, Inc.; Columbia, Northern (SC, KY); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Lexington Health, Inc. seeks a professional Medical Coder to assign ICD and CPT codes for hospital and outpatient services. You will follow ICD, CPT, CMS, and other regulatory guidelines and abstract clinical data from records for accurate statistics and reimbursement.

You must have 1 year of coding experience or a completed coding fellowship, plus licensure or certification (AAPC/AHIMA). Proficiency with CPT/ ICD coding, E/M guidelines, and payor requirements is essential.

Qualifications

• Minimum Education: High School Degree or Equivalent.
• Minimum Years of Experience: 1 Year of Experience in Professional Coding or Related Field.
• Substitutable Education & Experience: Coding fellowship may replace 1 year of experience.
• Certifications/Licensure: Licensure, Registry, or Certification required (AAPC or AHIMA coding credential or equivalent).
• Training: CPT/ICD coding, E/M guidelines (1995/1997/2021), Medicare LCDs/NCDs, payor billing requirements.

Responsibilities

• Reviews hospital-based professional services and outpatient documentation to assign ICD and CPT codes for reimbursement and statistics.
• Abstracts information into computer systems for reimbursement.
• Stays current with healthcare coding trends and compliance.

Skills

CPT ICD coding

E/M Documentation Guidelines

CCI edits

Medicare LCDs/NCDs

Regulatory payor billing requirements

EHR software

Education

High School Degree or Equivalent

Coding fellowship

Tools

Microsoft Word

Microsoft Excel

Outlook

EHR software

Job description

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Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bedteachinghospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcareand was first in the state to achieve Magnet with Distinctionstatus for excellence in nursing care. Consistently ranked as bestin the Columbia Metroarea by U.S. News & World Report, Lexington Healthdelivers more than 4,000babies each year, performs more than 34,000surgeries annually and isthe region's third largest employer.

Lexington Health also includes an accredited Cancer Center of Excellence, the state’s first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer’s care center.Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.

Job Summary

Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation.

Minimum Qualifications

Minimum Education: High School Degree or Equivalent
Minimum Years of Experience: 1 Year of Experience in Professional Coding or Related Field
Substitutable Education & Experience (Optional): In lieu of 1 Year of Experience, will consider successful completion of the coding fellowship.
Required Certifications/Licensure: Licensure, Registry, or Certification Required (AAPC or AHIMA coding credential required and/or specialty certification, as approved by Director);
*A CCA or CPC-A will only be eligible for those who have successfully completed the coding fellowship.
Required Training: Experience working with CPT, ICD diagnosis coding, E/M Documentation Guidelines (1995/1997/2021);
Experience with CCI edits;
Experience with Medicare LCDs and NCDs;
Understanding of state and federal regulations as well as payor billing requirements.
Must be computer literate and have experience with Microsoft applications (i.e., Word, Excel, Outlook);
Experience with electronic health records software.

Essential Functions

• Reviews and interprets hospital based professional services and outpatient medical documentation to accurately assign ICD and CPT codes for reimbursement and statistical purposes.
• Abstracts information into computer for reimbursement and statistical purposes.
• Researches and stays current with trends in healthcare coding and compliance.
• Keeps department manager up to date with any coding or documentation issues.
• Must work independently and collaboratively to support the achievement of department People, Quality, Finance, and Service goals as well as organizational goals.

Duties & Responsibilities

• Works as a team with physicians, coding staff and other personnel to ensure proper and accurate code assignment and continuous quality improvement.
• Responsible for assisting with coding claim edits and reviewing claim denials for correction.
• Reports to work in a timely manner and adheres to attendance policies. Conscientious of scheduling time off in advance so as not to interfere dramatically with coding turnaround times.
• Performs all other duties as assigned.

We are committed to offering quality, cost-effective benefits choices for our benefit eligible employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance – equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Student loan forgiveness

Equal Opportunity Employer
It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee’s desires and abilities and the hospital’s needs.