Specialized Coder - Cardiology, Vascular and CVTS

Reading, PA; Reading (Berks County); On-site; USD 60,000 - 90,000; Full time

Job summary

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, hospitals, and affiliated physician groups. This onsite role is located at Tower Reading Hospital in West Reading, PA.

The Specialized Coder will review physician charges and code encounters, mentor coders, and keep up with payer guidelines and Local/National Coverage Determinations to ensure accuracy and compliance.

Qualifications

• 3+ years of physician coding experience.
• Expert knowledge in Cardiology, Cardiovascular Thoracic Surgery or Vascular Surgery coding.
• Knowledge of ICD-10-CM, CPT, and HCPCS.

Responsibilities

• Code claims from medical records per coding guidelines.
• Complete work queues accurately and timely.
• Identify coding trends and assist leadership in resolution.
• Assist with research of denied claims and provider education.
• Mentor junior coders and share coding updates.
• Maintain compliance with policies and procedures.

Skills

Medical coding

CPC certification

ICD-10-CM

CPT

HCPCS

EPIC

Education

High School Diploma or GED

Tools

EPIC

Job description

Specialized Coder

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. This position is an onsite role located at Tower Reading Hospital in West Reading, PA.

The Specialized Coder is a certified coder with expert knowledge in physician coding for Cardiology, Cardiovascular Thoracic Surgery or Vascular Surgery. This position is responsible for reviewing physician charges to accurately code encounters, correct coding edits, and assist with research for denied claims. The Specialized Coder's role also includes tracking, trending coding issues, mentoring/training other coders, and supporting provider education.

Job Responsibilities:

• Code claims directly from the medical record/operative report according to coding guidelines.
• Accurate and timely completion of work queues as assigned.
• Track and identify trends within charge review and follow up work queues and assist leadership in the resolution of those trends and/or educational needs.
• Assists with research of denied claims.
• Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations.
• Provide and/or assist with provider education, as well as the development of educational tools.
• Communicates professionally with physicians, management, and peers.
• Participates in all educational activities including coding meetings/calls necessary to provide information relating to coding and compliance.
• Remains abreast of changes to current payer guidelines, Correct Coding Initiative edits, and Local/National Coverage Determinations for accuracy in Coding and mentors team members regarding coding guidelines and accuracy.
• Assists with training of other coders.
• Takes initiative for learning new skills and willingness to participate and share expertise on projects, committees and other activities as deemed appropriate.
• Demonstrates personal responsibility for job performance.
• Extensive knowledge/experience in physician coding with expert knowledge in a specific coding specialty and the ability to provide education/support to coding team and providers.
• Possible travel for education sessions, CME events, etc. as defined by Physician Revenue Cycle Leadership.

Required Experience:

• 3+ years of coding experience
• Extensive knowledge/experience in physician coding with expert knowledge in Cardiology, Cardiovascular Thoracic Surgery or Vascular Surgery coding specialty and the ability to provide education/support to coding team and providers.
• Knowledge of Medical Terminology, ICD-10-CM, CPT, and HCPCS.
• PC and Computer application knowledge and experience.
• Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).
• Excellent organization skills, communication, time management, trouble shooting and problem solving.
• Ability to multi-task and prioritize needs to meet short- and long-term timelines.
• Experience with EPIC and previous use of coding software tools.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Minimum Education: High School Diploma or GED Required

Certifications: Candidate must have and keep current at least one of the following professional certifications (CPC, preferred with the addition of CCVTC and/or CIRCC): CPC (Certified Professional Coder) CCS (Certified Coding Specialist) RHIA (Registered Health Information Administrator) RHIT (Registered Health Information Technician)

Join an award-winning company. Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.