Senior Coder - Outpatient

highmarkhealth; Pennsylvania; Hybrid; USD 33,000 - 51,000; Full time

Job summary

Highmark Health is seeking a skilled medical coder to perform thorough medical record review, abstract essential data, and assign ICD-10-CM/CPT codes for diagnoses and procedures to support accurate billing.

The role requires 5 years of hospital or physician coding experience, familiarity with trauma and teaching guidelines, and certifications such as CCS, RHIT, RHIA, or CPC. You will mentor colleagues and help ensure compliant coding practices.

Qualifications

• High School/GED required; 5 years hospital/physician coding experience.
• 1 year coding - all specialties/service lines.
• Knowledge of Trauma/Teaching/Observation guidelines.
• Certifications CCS/RHIT/RHIA/CCS-P/CPC/COC preferred.

Responsibilities

• Review and interpret medical information to assign ICD-10-CM/CPT codes.
• Abstract data elements and enter into designated system.
• Manage unbilled coding report to support cash flow.
• Stay updated on ICD-10 CM/CPT guidelines through training.
• Mentor and act as subject matter expert to others.
• Perform additional duties as assigned.

Education

High School/GED

Associate's Degree

CCS

RHIT

RHIA

CCS-P

CPC

COC

Job description

GENERAL OVERVIEW

This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days.

ESSENTIAL RESPONSIBILITIES

• Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (60%)
• Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%)
• Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%)
• Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. (5%)
• Acts as a mentor and subject matter expert to others. (5%)
• Performs other duties as assigned or required. (5%)

QUALIFICATIONS

• Minimum
• High School/GED
• 5 years of Hospital and/or Physician Coding
• 1 year of Coding - all specialties and service lines
• Extensive knowledge in Trauma/Teaching/Observation guidelines
• Successful completion of coding courses in anatomy, physiology and medical terminology
• Any of the following:
• Certified Coding Specialist (CCS)
• Registered Health Information Technician (RHIT)
• Registered Health Information Associate (RHIA)
• Certified Coding Specialist Physician (CCS-P)
• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Preferred
• Associate's Degree

Disclaimer

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range

Minimum:

$23.73

Maximum:

$37.14

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

EEO/DEI

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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