Coder II – Pulmonary, Rheumatology, Sleep Medicine

Role Overview

• Reviews medical documentation at a proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS.
• Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations an EMR and/or Computer Assisted Coding software.
• Adheres to the organization and departmental guidelines, policies and protocols.
• Reviews all clinician documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes.
• Conduct independent research to promote knowledge of coding guidelines, regulatory policies and trends.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
• Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
• Maintains the confidentiality of patient records.
• Reports any perceived non-compliant practices to the coding leader or compliance officer.
• Meets then exceeds departmental quality and productivity standards.
• Recommend modifications to current policies and procedures as needed to coincide with government regulations.
• Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable

Requirements

• Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)
• Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge)
• Typically requires 3 years of experience in professional coding that includes experiences in either hospital or professional revenue cycle processes and health information workflows
• Advanced knowledge of ICD, CPT and HCPCS coding guidelines
• Advanced knowledge of medical terminology, anatomy and physiology
• Intermediate computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short
• and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program