Senior Coder

CommonSpirit Health; Phoenix (AZ); Remote; USD 60,000 - 90,000; Full time

Job summary

CommonSpirit Health is seeking a Senior Coder to lead coding responsibilities within a remote team. You will ensure compliance with coding guidelines, assign codes for various procedures, and train staff. This role requires a high level of expertise in ICD and CPT standards, along with 3+ years of coding experience in healthcare settings.

Qualifications

• At least 3 years of coding experience in hospital facility or related settings.
• Current coding certification (e.g., CCA, CCS, CPC).
• Knowledge of coding compliance regulations and standards.

Responsibilities

• Ensure compliance with coding standards and regulations.
• Assign and verify accurate diagnosis and procedure codes.
• Train new staff and contribute to departmental operations.

Skills

ICD knowledge

CPT knowledge

HCPCS guidelines

Analytical skills

Attention to detail

Education

High School Diploma or GED

Completion of accredited coding program

Tools

Microsoft Office

Google Workspace

Job description

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites, and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses, and 25,000 physicians and advanced practice providers across 24 states. The organization contributes more than $4.2 billion annually in charity care, community benefits, and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

This remote position encompasses a 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 will also audit coders, fill in for absent staff, and recommend improvements to Coding Leadership.

Responsibilities include:

1. Compliance with all relevant laws, rules, and regulations.
2. Reporting suspected violations of law.
3. Following coding guidelines set by AHIMA, NCCI, CMS, and coding ethics standards.
4. Selecting appropriate assignments from work queues.
5. Assigning codes by encounter, including selecting principal diagnosis and procedure codes, sequencing to optimize reimbursement, and coding only documented diagnoses and procedures.
6. Verifying charges against documentation when policies define this process.
7. Routing charges discrepancies to the department.
8. Utilizing coding systems effectively to code and abstract encounters.
9. Analyzing APCs and modifiers for accuracy and compliance.
10. Using ICD and CPT knowledge and resources to select appropriate codes.
11. Ensuring codes are not altered to misrepresent data or affect payment improperly.
12. Consulting physicians for clarification of ambiguous documentation.
13. Assisting physicians with ICD, CPT, or DRG methodologies.
14. Striving for optimal payment without engaging in unethical practices.
15. Reviewing unbilled records for timely coding.
16. Maintaining confidentiality at all times.
17. Fostering teamwork and assisting colleagues as needed.
18. Monitoring coding backlog and errors.
19. Collaborating with other departments to correct data inaccuracies.
20. Reviewing APC grouper edits and assisting in resolving coding and compliance issues.
21. Training new employees and providing input on policies.
22. Fulfilling continuing education and credential maintenance requirements.
23. Participating in meetings and contributing to departmental operations.

Qualifications include:

• At least 3 years of coding experience in hospital facility, professional fee, or physician clinic settings, with knowledge of ICD, CPT, APCs, DRGs, and modifiers. EMR or Cerner experience preferred.
• High School Diploma or GED, plus completion of an AHIMA or AAPC accredited coding program.
• Current registration or certification (e.g., CCA, CCS, CCS-P, RHIT, RHIA, CPC, CPC-A, COC).
• Deep knowledge of CPT, ICD, and HCPCS guidelines.
• Proficiency in Microsoft and Google Workspace; remote work experience is a plus.