Professional Services Coder

Renown Health; Reno, Eugene (NV, OR); On-site; USD 100,000 - 125,000; Full time

Job summary

An established industry player is seeking a detail-oriented coding professional to ensure accurate diagnostic and procedural coding. This role involves translating patient information into medical codes, adhering to strict guidelines for optimal reimbursement. You will work closely with clinicians and billing teams, utilizing your expertise in ICD-10-CM and CPT coding to maintain high standards of coding quality. If you are passionate about healthcare coding and looking for a position that values integrity and accuracy, this opportunity is perfect for you.

Qualifications

• Proficient in ICD-10-CM and CPT coding systems.
• Minimum 2-5 years of pro-fee coding experience required.

Responsibilities

• Assign diagnostic and procedural coding for all encounters.
• Research and resolve coding and reimbursement issues.

Skills

ICD-10-CM Coding

CPT Coding

Medical Terminology

Critical Thinking

Problem Solving

Anatomy and Physiology

Education

High School Diploma/GED

Tools

Microsoft Office Suite

EPIC

Job description

100737 Professional Billing

Reno, NV

Full Time - Eligible for Benefits

Clerical & Administrative Support

Day

Posted 01/29/2025

Between 6am-6pm PST W-Su

Req # 182116

Remote Worker

Salary: 24.44 - 34.21

Biweekly Hours: 80

Position Purpose

To be responsible for accurately assigning diagnostic and procedural coding for all encounters associated with Renown Health Network and Ambulatory Services. This will also include translating patient information into alpha-numeric medical codes using patient treatment, health history, diagnosis, and related information. Assignment of ICD-10-CM and CPT codes must be consistent with CMS' Official Guidelines and any regulatory agency guidelines.

Nature and Scope

Incumbents must be proficient with CPT and ICD-10-CM coding systems and responsible for assigning ICD-10-CM diagnoses codes and CPT procedure codes accurately and completely to ensure optimal reimbursement and coding quality. Coders in this position are held accountable for adhering to coding guidelines; accounts must be coded within the quality and productivity standards specified by department leadership. Incumbent is responsible for abstracting, analyzing, and assigning ICD-10-CM, CPT, HCPCS codes and appropriate modifiers for evaluation and management (E/M), minor procedures, and diagnostic tests by using either computerized or manual systems. Researches and resolves coding and reimbursement issues to ensure the accuracy, quality, and integrity of coding practices. Other responsibilities include: * Assigns codes for diagnoses, treatments, and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers. * Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner. * Able to accurately abstract information from the medial records into the abstract system, according to established guidelines. * Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines. * Enters and validates codes, charges and other edits flagged in EPIC for review. * Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units) * Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD's/NCD's for medical necessity. * Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns. * Meet and/or exceeds the established coding productivity standards. * Effectively communicates with clinicians and billing/coding teams regarding code changes and denials. * Code/Audit encounters within the Professional Services Coding Epic queues. * Complete accountable work related to daily unbilled charges to ensure timely billing in conjunction with billing and compliance guidelines. * Address appeals and review documentation needed for insurance denials to facilitate expedient resolution and reimbursement. **Staff are required to work 8 hours daily, Wed - Sun between the hours of 6am and 6pm PST** KNOWLEDGE, SKILLS & ABILITIES Knowledge of Anatomy and Physiology, Pharmacology, Disease Pathology, and Medical Terminology. Knowledge of modifiers, ICD-10-CM, CPT (including E/M) and HCPCS coding. Knowledge of Evaluation and Management Guidelines and auditing to assist in provider education and identifying possible revenue opportunities. Conversion of written description to proper billing codes. Ability to appeal CPT and ICD-10-CM for maximum reimbursement. Utilize critical thinking and problem-solving abilities. Comprehension of disease processes. Ability to work well with others. Ability to navigate the Electronic Medical Record to identify appropriate documentation for coding/billing in support of submitted department charges. Uphold a strong work ethic characterized by honesty and dependability. Demonstrate personal time management skills, including organization, prioritization, and multitasking. Adherence to company policies, procedures, and directives. This position does not provide patient care.

Disclaimer

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications

Name	Description
Education:	Must have working-level knowledge of the English language, including reading, writing and speaking English. High School Diploma/GED required.
Experience:	A minimum of 2-5 years previous pro-fee coding experience required. Experience in medical billing, and Professional Billing EMR workflows is preferred.
License(s):	None
Certification(s):	CCS, CCS-P, CPC, COC and/or CIC Coding credential required. (Excludes apprenticeship classification)
Computer / Typing:	Must be proficient with Microsoft Office Suite, including Outlook, Power Point, Excel, and Word. Must have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Actual salary offered may vary based on multiple factors, including but not limited to, an individual's location and their knowledge, skills, and experience as well as internal equity.