Senior Coder

Dignity Health; Phoenix (AZ); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Coder for a remote position. This role involves a variety of coding responsibilities including outpatient facility coding, E/M level coding, and compliance auditing. The ideal candidate will have at least 3 years of experience and relevant coding certifications, providing essential support and training to the coding team.

Qualifications

• Minimum 3 years of coding experience in hospital facilities or clinics.
• Knowledge of ICD, CPT, APCs, DRGs, and modifiers required.
• Deep knowledge of coding guidelines and remote work experience essential.

Responsibilities

• Ensure compliance with coding regulations and guidelines.
• Audit coders and recommend improvements.
• Train new employees on coding procedures.

Skills

ICD knowledge

CPT knowledge

APCs

DRGs

teamwork

Education

High school diploma or GED

Completion of AHIMA/AAPC accredited coding program

Certification such as CCA, CCS, CCS-P, RHIT, RHIA, CPC, CPC-A, or COC

Tools

EMR systems

Cerner systems

EHR systems

encoder systems

Microsoft Workspace

Google Workspace

Job description

Responsibilities

This remote position involves a range of coding duties, including outpatient facility coding (Diagnostic, Observation, Endo, & Surgery), evaluation and management (E/M) level coding for clinical office visits, and professional fee coding. Placement will depend on experience, with cross-training provided to ensure proficiency across all areas.

The Senior Coder serves as a lead for their team, training staff on policies, procedures, systems, and coding requirements. They will audit coders, cover for absent team members, and recommend improvements to Coding Leadership.

Key Responsibilities include:

1. Ensuring compliance with all relevant laws, rules, and regulations.
2. Reporting suspected violations of law.
3. Following coding guidelines from AHIMA, NCCI, CMS, and ethical standards.
4. Assigning codes accurately from work queues, including selecting principal diagnoses and procedures, and sequencing for reimbursement.
5. Ensuring documentation supports codes, consulting physicians when needed.
6. Verifying charges match documentation and routing discrepancies appropriately.
7. Using coding systems correctly to code and abstract encounters.
8. Analyzing APCs and modifiers for accuracy.
9. Applying ICD and CPT rules to select appropriate codes, maintaining data integrity.
10. Consulting physicians for clarification on ambiguous documentation.
11. Supporting physicians unfamiliar with coding methodologies.
12. Striving for optimal, compliant reimbursement.
13. Reviewing unbilled records for timely coding.
14. Maintaining confidentiality at all times.
15. Promoting teamwork and assisting colleagues.
16. Monitoring coding errors and backlog.
17. Collaborating with other departments to correct information.
18. Reviewing and clearing coding edits.
19. Training new employees and providing input on policies.
20. Completing ongoing education and maintaining credentials.
21. Participating in meetings and performing additional duties as assigned.

Qualifications

Minimum 3 years of coding experience in hospital facilities, professional fee, or physician clinics, with knowledge of ICD, CPT, APCs, DRGs, and modifiers. Experience with EMR or Cerner systems. High school diploma or GED, plus completion of an AHIMA/AAPC accredited coding program. Certification such as CCA, CCS, CCS-P, RHIT, RHIA, CPC, CPC-A, or COC is required. Deep knowledge of CPT, ICD, and HCPCS guidelines, proficiency in Microsoft or Google Workspace, and remote work experience are essential. Familiarity with EHR and encoder systems is also required.

Overview

CommonSpirit Health is committed to building a healthier future through integrated health services. As one of the largest nonprofit Catholic healthcare organizations, it delivers over 20 million encounters annually across numerous clinics, hospitals, and services. With over 157,000 employees and significant community contributions, it aims to create a just, equitable, and innovative healthcare system.