Sr Multi Specialty Medical Coder

R1 RCM; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare solutions provider is seeking a Multispecialty QA Education Coding Associate to review clinical documentation and accurately assign coding for billing. The ideal candidate should have a high school diploma or GED, along with CCS-P or CPC certification, and at least 5 years of experience in multispecialty coding. This position offers a competitive benefits package and opportunities for career growth.

Benefits

Competitive benefits package

Qualifications

• 5 years experience in multispecialty coding.
• 5 years experience in QA and auditing.
• 3 years experience with Excel.

Responsibilities

• Assign codes for diagnoses and procedures according to classification systems.
• Review physician assigned diagnosis codes after reviewing medical records.
• Enter and validate codes and charges flagged for review.

Skills

Multispecialty coding

Analytic background

Effective communication

Excel proficiency

Education

High School Diploma or GED

CCS-P, CPC

Job description

Overview

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We combine the deep expertise of a global workforce of revenue cycle professionals with an advanced technology platform, including analytics, AI, intelligent automation, and workflow orchestration.

Multispecialty QA Education Coding Associate will review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance. Under the direction of the Coding Leadership Team, the candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.

What you can expect as our Multispecialty QA Education Coding Associate:

• Assigns codes for diagnoses, treatments and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
• Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.
• Able to accurately abstract information from the medical records into the abstract system, according to established guidelines.
• Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC and adheres to official coding guidelines.
• Enters and validates codes, charges and other edits flagged in Athena or EPIC for review.
• Reviews documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (e.g., NDC number or number of units).
• Uses CCI edit software to check bundling issues, modifier appropriateness, and LCDs/NCDs for medical necessity.
• Communicates with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns.
• Meets and/or exceeds the established coding productivity standards.
• Meets and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards.

Required Qualifications:

• High School Diploma or GED
• CCS-P, CPC
• 5 years experience in multispecialty coding
• 5 years experience in QA and auditing
• 3 years experience with Excel
• Ability to identify tracks and trends
• QA education and training
• Strong analytic background
• Proficiency in professional services (95% accuracy)
• Extensive knowledge of official coding conventions and rules established by AMA (e.g., Documentation Guidelines ’95 & ’97)
• Extensive knowledge of government and commercial payer guidelines
• Ability to use standard office equipment and information systems
• Ability to interact with other employees through effective communication
• Ability to prioritize and shift workloads to align with revenue cycle goals

For this US-based position, the base pay range is $20.13 - $31.13 per hour. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

The healthcare system is evolving — you will have the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are encouraged to contribute, think boldly, and create meaningful work that makes a difference in the communities we serve. We offer a competitive benefits package.

R1 RCM Inc. is dedicated to equal employment opportunity. Our employment practices, including recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination, shall not be based on protected characteristics. We are committed to a workplace free from harassment.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

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To learn more, visit: R1RCM.com

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