Senior Coder

Common Spirit; Phoenix (AZ); Remote; USD 60,000 - 80,000; Full time

Job summary

Common Spirit Health is seeking a Senior Coder for a remote position responsible for outpatient facility coding and professional fee coding. The ideal candidate will lead a coding team, ensuring compliance with guidelines and providing training. A minimum of 3 years of experience and relevant certifications are required.

Qualifications

• Minimum 3 years of coding experience in healthcare settings.
• Certification such as CCA, CCS, or CPC required.
• Deep knowledge of coding guidelines essential.

Responsibilities

• Lead coding team and ensure compliance with coding standards.
• Train staff on policies and coding requirements.
• Audit coder performance and recommend improvements.

Skills

CPT coding

ICD coding

HCPCS coding

Compliance

Communication

Teamwork

Education

High School Diploma or GED

Completion of AHIMA/AAPC accredited coding program

Certification (CCA, CCS, etc.)

Tools

EMR systems

Cerner systems

EHR systems

Encoder systems

Microsoft Workspace

Google Workspace

Job description

Responsibilities

This remote position involves a diverse range of coding responsibilities, 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 be based on experience, with comprehensive cross-training available to ensure proficiency across all areas. The Senior Coder acts as a lead for their team, training staff on policies, procedures, systems, and coding requirements. They also audit coders, cover for out-of-office staff, and recommend improvements to Coding Leadership.

Key Responsibilities:

• Ensure compliance with all applicable laws, rules, and regulations.
• Report suspected violations to supervisors or compliance officers.
• Follow coding guidelines set by AHIMA, NCCI, CMS, and ethical standards.
• Select appropriate assignments from work queues.
• Assign codes by encounter, including selecting principal diagnoses and procedures, sequencing for reimbursement, and ensuring documentation support.
• Communicate with physicians for clarification when needed.
• Verify charges match documentation and route discrepancies appropriately.
• Utilize coding systems accurately to code and abstract encounters.
• Analyze APCs and modifiers for accuracy and compliance.
• Use ICD and CPT knowledge to select appropriate codes, maintaining code integrity.
• Consult physicians for clarification on ambiguous documentation.
• Assist physicians unfamiliar with coding methodologies.
• Strive for optimal payment within regulatory guidelines, avoiding unethical practices.
• Review unbilled records for timely coding.
• Maintain confidentiality of patient, record, department, and employee data.
• Foster teamwork and assist colleagues as needed.
• Monitor coding backlog and errors, working with other departments to correct data.
• Review APC grouper edits and assist in resolving related issues.
• Train and orient new employees.
• Provide input on coding policies and procedures.
• Complete continuing education and maintain credentials.
• Participate in meetings and contribute to departmental operations.

Qualifications:

• Minimum 3 years of coding experience in hospital facility, professional fee, or physician clinic settings using ICD and CPT.
• Experience with EMR or Cerner systems.
• High School Diploma or GED, with completion of an AHIMA/AAPC accredited coding program.
• Certification such as CCA, CCS, CCS-P, RHIT, RHIA, CPC, CPC-A, or COC, and ongoing credential maintenance.
• Deep knowledge of CPT, ICD, and HCPCS coding guidelines.
• Basic computer skills, proficiency in Microsoft or Google Workspace.
• Remote work experience and knowledge of EHR and Encoder systems.

About CommonSpirit Health:

Inspired by faith, driven by innovation, powered by humankindness, we are building a healthier future through integrated health services. As a leading nonprofit Catholic healthcare organization, we deliver over 20 million patient encounters annually across numerous clinics, hospitals, and virtual services. Our team of over 157,000 employees is committed to creating a more just, equitable, and innovative healthcare system.